Title: The Emergency Medical Treatment and Active Labor Act (EMTALA) and Its Effects - AAF
Headings: The Emergency Medical Treatment and Active Labor Act (EMTALA) and Its Effects
Insight
The Emergency Medical Treatment and Active Labor Act (EMTALA) and Its Effects
Enforcement
Conclusion
Brittany La Couture
Former Health Policy Counsel
Brittany La Couture
Former Health Policy Counsel

Content: The Emergency Medical Treatment and Active Labor Act (EMTALA) and Its Effects - AAF
Insight
May 14, 2015
The Emergency Medical Treatment and Active Labor Act (EMTALA) and Its Effects
Brittany La Couture
The Emergency Medical Treatment and Active Labor Act (EMTALA), enacted in 1986, is intended to prevent hospitals from “patient dumping” indigent or high-risk patients by transferring them to public hospitals or refusing to provide care. [ 1]
EMTALA requires that all Medicare participating hospitals with Emergency Departments (EDs) provide stabilizing emergency care for all patients seeking help (including women in labor), regardless of their insurance status or ability to pay. [ 2] These hospitals are required to examine everyone who comes through the doors of the emergency department (or, in fact, enters hospital property seeking care), and scan them for emergent medical conditions. The hospital is then required to either treat or stabilize the patient. [ 3]
Ensuring a patient is stabilized requires that, within reasonable medical certainty, no material deterioration in the patient’s condition should occur during transfer or upon discharge from the hospital. For purposes of EMTALA, any transport of a patient is considered a “transfer” – even if the patient is going home, therefore all transfers must also be accompanied by a request for transfer by the patient, along with informed consent. [ 4] Alternatively, a certification by a physician could accompany the transfer order if the benefits of transferring the patient outweigh the risks, and that the transfer is appropriate. For example, if the transfer is to a hospital with a specialty burn unit or a children’s hospital. On the other hand, EMTALA also requires that all hospitals with specialty units, such as a burn ward, accept transfers to those units to the extent of their capacity. This restriction is in place to prevent what is known as “reverse dumping,” whereby a specialty hospital, which might lack the appropriate capacity, sends patients with specific needs back to a referring hospital without the capacity to meet those needs. [