What Is The Emergency Medical Treatment and Active Labor Act (EMTALA)? Why Is It Important?


EMTALA is the federal law that ensures people can access emergency care, whether or not they can pay. When someone goes to the emergency room with a medical emergency they must be seen, receive a medical screening exam and be stabilized if the hospital has the ability to do so. Generally, people interpret it to mean: a hospital can’t turn a patient away without the benefit of a medical screening examination.

Of course nothing is simple and EMTALA carries its own controversy along with it. People tend to fall into one of two camps: Either EMTALA is one of the great things about living in America -- it ensures that people who need emergency care receive it. It’s a safety net.

Or, others believe that EMTALA drives up the cost of healthcare and adds to financial difficulties hospitals experience. That’s because when EMTALA was written into law, funding was not written into the federal budget to pay for it. 

How does EMTALA affect to emergency departments?

Some pinpoint EMTALA as a cause for emergency department overcrowding. Politics and opinions aside, as an emergency department, you must be ready to evaluate and stabilize basically any and all who come your way. To do that you need to make sure the following are in place and buttoned up:

  • intake and triage processes
  • patient flow protocols
  • staffing and scheduling procedures

Failing to provide medical screening examination and stabilize patients can cost you in penalties and lawsuits.

Why does EMTALA matter to doctors and hospital administrators?

You need to know what the law requires. When patients show up at your door, every effort must be made to complete a medical screening exam and initially stabilize the patient within the abilities of your hospital. Know that if your hospital cannot fully stabilize a patient, you must transfer them to another facility with the capabilities to do so. You must also transfer the patient, if they request to be transferred.

The nuances of EMTALA are not always easy and it can get tricky. How can you be sure you’re complying with EMTALA? You may wonder what counts as an “emergency medical condition”? What should your medical examinations involve to make sure you are providing a screening that will comply as an “emergency medical screening” under the law?

For these questions, it is best to go by the book. Luckily, the Center for Medicaid and Medicare Services have these online resources so you can look up the law.

You need to know what counts as an emergency. For a brief explanation of what counts as an emergency condition, the American College of Emergency Physicians summarizes it this way:

“An emergency medical condition is defined as ‘a condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in placing the individual's health [or the health of an unborn child] in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of bodily organs.’”

You need to be prepared to cover the costs. And since seeing patients who seek care but cannot pay does cost money, physicians and hospitals are left absorbing that cost. According to the American College of Emergency Physicians: “Emergency physicians provide the most charity care of all physicians (AMA 2003).”

 Because of this, the group advocates for ways to get emergency doctors compensated for EMTALA patients and federal guidance on how to comply with the law.

 The cost of treating patients who cannot pay is passed down to hospitals and may ultimately be passed down to other patients at the hospital.

Who gets fined for EMTALA violations?

Physicians can be fined up to $50,000 per violation and lose their ability to receive Medicare reimbursements. Depending on its size, the hospital can also be fined up to $50,000, or more, depending on the number of violations. A hospital can also lose its Medicare funding, a significant source of revenue in most hospitals. A hospital can also sue another hospital that passes along a patient that isn’t stabilized.

How can Donovan and Partners help with challenges associated with EMTALA? 

While Donovan and Partners is not an EMTALA compliance specialist, we can help you take a look at your emergency department’s protocols and procedures to make sure you are capable of handling some of the situations that EMTALA can create and ensure that everyone gets quality care. We can help you examine and improve your:

  • emergency department’s intake and triage process
  • patient flow protocols
  • staffing and scheduling procedures

We’ll help you implement best practices so you’re prepared and in good position to handle any strains EMTALA may cause. In addition, we can also help with CMS response and action plan development in the event you are cited. Contact us today at cmd@constancedonovan.com or 651-260-9918.


Centers for Medicare and Medicaid Services: “Emergency Medical Treatment & Labor Act (EMTALA)”

American College of Emergency Physicians: “EMTALA”