Health Advisory: CMS Final Rule Clarifies Hospital Responsibilities Under EMTALA
9/12/2003
The Centers for Medicare and Medicaid Services (CMS) have published the long awaited final rule clarifying hospitals? obligations to individuals who request treatment for emergency medical conditions under the Emergency Medical Treatment and Labor Act (EMTALA), also known as the patient antidumping statute. The final rule is designed to reduce confusion and ease some of the burdens on hospital emergency departments, while still ensuring that individuals will receive appropriate screening and emergency treatment, regardless of their ability to pay. The final rule becomes effective November 10, 2003.
This publication describes a number of issues clarified in the final rule:
- Definition of "Comes to the emergency department"
- Obligations when nonemergency conditions present at the emergency department
- Redefinition of term "patient" and determination of when Medicare CoPs cover patients instead of EMTALA
- On-call requirements
- Responsibilities regarding insurance prior authorizations and provision of necessary services
