EMTALA: OIG/HCFA Special Advisory Bulletin Clarifies EMTALA, American College of Emergency Physicians Criticizes it

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In December 1998, the Office of Inspector General (OIG) and the Health Care Financing Administration (HCFA) solicited comments from health care providers regarding the federal anti-patient dumping statute, the Emergency Medical Treatment and Active Labor Act (EMTALA) (42 USCA §1395dd). EMTALA is a federal health care law of unprecedented breadth—the first universal benefit guaranteed by the federal government. It requires Medicare-participating hospitals with public emergency rooms, emergency physicians, and ancillary surgical and medical specialists to render adequate stabilizing treatment to whoever requests it. The 1998 Special Advisory Bulletin (63 FR 67486-01) sought input on four principal dimensions of EMTALA: (1) the statutory obligation to furnish adequate medical screening to anyone who visits an emergency room; (2) the responsibilities of health care providers towards enrollees of managed care organizations (MCOs); (3) the prior authorization and payment rules for Medicare and Medicaid; and (4) what practices would promote hospital compliance with EMTALA.