EMTALA Compliance and Enforcement
The focus of our health law practice is representation of medical practices, physicians, healthcare providers and licensed professionals, as well as numerous types of healthcare businesses. We are devoted to providing high quality legal services for healthcare industry clients and assisting medical professionals throughout the United States.
We have represented hundreds of physicians. In doing so, we endeavor to understand the unique regulatory and legal environment they confront every day, having chosen healthcare as their livelihood or business.
The Adverse Professional Consequences of Alleged Patient Dumping
Hospitals and emergency room physicians must comply with the Emergency Medical Treatment and Active Labor Act (EMTALA). EMTALA was passed in 1985 as a result of concerns that emergency departments regularly turned away indigent and uninsured patients or improperly sent them to other hospitals. EMTALA requires hospitals that participate in Medicare to give every patient a medical screening regardless of ability to pay. If the patient has an emergency medical condition, the hospital must stabilize the patient or provide for appropriate transfer to another hospital.
Our health law firm represents and protects physicians and other healthcare providers with regard to federal law enforcement investigations of, among other regulatory matters, alleged EMTALA violations. If you are a physician subject to an EMTALA investigation by the federal government, our health law firm can help you. Contact us to schedule a confidential consultation to discuss your circumstances.
Often, the allegation that a physician has violated EMTALA can raise various unsavory -- and potentially severe -- employment, professional and/or financial consequences for the physician, largely due to the potential business and financial consequences for a hospital if an EMTALA violation is determined. Typically, a hospital subject to an EMTALA investigation must of business necessity take some mitigating measures or “corrective action” to address the alleged violation and avoid be terminated from the Medicare program. Such measures can involve disciplinary action against a physician, and such action can create long-term or permanent credentialing and related problems for the physician. The OIG can fine a hospital up to $50,000 per violation (or $25,000 for a hospital with fewer than 100 beds). The physician responsible for examination, treatment tor transfer, including an on-call physician, can be fined up to $50,000 by OIG. Even worse, the physician can be excluded by OIG from the Medicare program, which can, of course, dramatically impact the physician’s employability by a hospital or medical practice.
A huge difficulty for emergency room physicians is the uncertainty about the extent of their responsibilities under EMTALA. According to a recent OIG survey, “[m]ore than 40 percent of emergency room physicians and more than 60 percent of emergency room directors . . . reported that some parts of the EMTALA law or regulations were unclear.” CMS conducts about 400 EMTALA investigations each year, and, according to its website, about half of the investigations result in confirmed violations. The gray area is a source of risks for emergency room doctors and departments.
The Centers for Medicare and Medicaid Services (CMS), through the Department of Health and Human Services (HHS), investigates complaints of EMTALA violations. The Office of Inspector General (OIG) is the federal law enforcement agency charged with responsibility to levy appropriate civil fines and penalties
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