During certain kinds of emergencies, your hospital may be able to expect a relaxation of Emergency Medical Treatment and Labor Act (EMTALA) rules based on new language that CMS has added to the State Operations Manual's Interpretive Guidelines relating to EMTALA waivers.
Under the updated guidelines, hospitals and critical access hospitals operating under an EMTALA waiver will not be sanctioned for:
- Redirecting an individual who comes to the ED from another location for a medical screening exam, according to a state emergency preparedness plan or state pandemic preparedness plan.
- Inappropriately transferring an individual protected under EMTALA, when the transfer is necessitated by the circumstances of the declared emergencies.
EMTALA--aka, the patient anti-dumping law--requires anyone coming to an emergency department to be stabilized and treated, regardless of their insurance status or ability to pay. Hospital managers will still need to be aware of whether certain conditions have been met before seeking a waiver.
An EMTALA waiver may be issued only when the president has declared an emergency or disaster, the HHS secretary has declared a public health emergency, and she has exercised her waiver authority by delegating to CMS to decide which requirements should be temporarily waived or modified and for which kinds of providers.
For an EMTALA waiver to apply to a specific hospital or critical access hospital, the hospital must activate its disaster protocol and the state must have activated an emergency-preparedness or pandemic-preparedness plan in the emergency area. Any redirection of individuals for medical screenings must follow the plan.
CMS' changes spell out the conditions under which allowing the inappropriate transfer or direction or relocation of an individual for medical screenings at another location won't expose your hospital to penalties. Sanctions may be waived if the transfer is necessitated by a declared emergency in the emergency area during an emergency, according to CMS.
The updated guidelines also define when a waiver can be issued, what criteria have to meet for an EMTALA waiver to apply to a specific hospital or critical access hospital, and how to apply for an EMTALA waiver.
To learn more:
- read the revised waiver guidelines
- check the CMS transmittal site for the update
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