Paper Example on EMTALA Policy: Ensuring Equal Access to Emergency Healthcare

Introduction

In 1986, the United States Congress passed the Emergency Medical Treatment and Active Labor Policy (EMTALA) to be integrated into the Consolidated Omnibus Reconciliation Acts, a policy deemed as a resolution to Medicare challenges. The EMTALA policy was established to guarantee all patients that they will have access to emergency health care. Consequently, the policy was determined to end situations in which insured patients are transferred from private healthcare facilities to public medical facilities for financial reasons (Bernardo, 2017). Before, the establishment of the act, it was typical for uninsured patients to be transferred to a different health facility without the consideration of the patients’ medical stability or condition. In that perspective, EMTALA act is considered to be most significant policy that guarantees fair accessible to hospitals, especially in emergent situations. The Center for Medicare and Medicaid Service (CMS) initially known as known as the Health Care Financing Administration established the EMTALA policy with the intention that all patients whether insured or not will have access for emergent medical services.

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How EMTALA Policy Integrates with the Entire Healthcare System

The entire U.S healthcare systems should adhere to the EMTALA policy regulations. The act entails that all healthcare facilities in the United States and especially the emergency department should take urgent medical actions without taking into consideration of the legal status, financial capability or citizenship of a patient that is in critical condition (Miller, 2013). It is a federal policy that all states within the U.S should abide by.

All patients must pass through the Medical Screening Examination. The EMTALA policy ensures that all patients must be screened to determine if they need medical urgent treatment. In the case of an emergency situation, the particular health care facility is mandated to take urgent medical attention without making inquiries concerning the terms of condition of the insurer or means of payment (Zuabi et al., 2016). The EMTALA policy entail the above-mentioned inquiries should only be made when the patient in in stable condition or if the process does not interfere with the patient wellbeing.

Consequently, the policy supports the act that participating healthcare facilities should not discharge or transfer patients seeking medical treatment except with stabilization or informed consent of the patients. Similarly, the public health law supports the EMTALA act in specific areas such as eliminating the practice of 'patient dumping" or the refusal to treat patients because of insufficient insurance or inability to pay for the medical bills or discharging the patients even in an emergency based on expensive diagnoses and treatment cost (Rosenbaum, 2014). In that perspective, the policy advocates for equal treatment for all regardless of their citizenship or legal status in emergencies to minimize patient dumping or discharging patients due to their inability to pay their medical bills.

Nonetheless, the EMTALA policy entails that healthcare facilities are only mandated to transfer a patient to a different healthcare in the case it lacks the capability to provide emergency care to the patient in question (Zuabi et al., 2016). The receiving has the right to report to the Center for Medicare and Medicaid Service in a situation in which unstable patient was received in violation of the EMTALA act. The reason is that the provision, the physician authorizing the transfer must determine whether the patient is in stable condition to avoid deteriorating the patient situation.

Consequences for Non-Compliance

Healthcare facilities non-complying to the EMTALA policy may lead to legal actions. Non-compliance attracts penalties when the Civil Right agency determine that there was any form of discrimination used in the manner in which a certain healthcare facility handled a patient in an emergency situation. In the case a healthcare is found guilty of violating the EMTALA policy, the facility is given the option of either submitting a strategy to rectify the CMS or the healthcare facility losing status of a Medicare provider for at least 24 days (Zibulewsky, 2014). If the first option is chosen, the medical facility is monitored for three months with the objective of ensuring the healthcare facility complies with the EMTALA rules and regulations. The CMS report depicts that the violation of the EMTALA policy can attract a fine of at least $ 50,000 for healthcare facilities with less than 100 medical beds, and the same amount for the physician involved in the incidence.

EMTALA Policy Challenges

The EMTALA policy requirements may appear straightforward, but it is challenging to fulfill them. Well-established healthcare facilities have to use considerable effort to exhaust their capacity and capabilities. On the other hand, healthcare facilities with limited resources or in rural setting may experience challenges accessing the equipment desire to analyze and stabilize a patient (Hughes, 2014). A healthcare’s responsibility to stabilize a patient “within its efforts” includes not only the medical care that can be provided by the healthcare provider on site, but as well the interdisciplinary member such as physicians and nurses on the facility’s on-call roster. Additionally, finding a qualified healthcare facility for an appropriate transfer can be equally challenging (Zibulewsky, 2014). The reason is that the EMTALA policy entails that if a healthcare facility is not capable of stabilizing a patient medical situation, then it is obligated to transfer the patient to a healthcare that has the capacity and capability do so, even if the facility is not in proximal location. It can be specifically challenging in situation where emergency medical conditions triggering EMTALA policy rules and requirements is vague or challenging to interpret such as a patient complaining of extreme or in situation in which stabilization requires special treatment such as behavioral health emergencies.

Recommendation to Enhance EMTALA Policy Compliances

In light of such developments, healthcare facilities and compliance officers should take the opportunity to evaluate the EMTALA procedures, especially concerning the resources and policies in place for treatment and evaluation of behavioral health patients present at the emergency department (Zhou et al., 2019). Additionally, healthcare facilities managers should communicate with their interdisciplinary team members concerning the expectations surrounding the treatment and evaluation of emergency department patients, as EMTALA policy oversight extend beyond healthcare policies and operations to the decisions made by doctors themselves.

Conclusion

Although the EMTALA policy is a controversial topic for a lot of healthcare facilities in the United States, its establishment was vital for all patients to have medical access irrespective of their legal status, citizenship, or their financial capabilities. The EMTALA policy entails that it is the violation of the CMC when a healthcare facility does not stabilize a patient in an urgent situation of the facility has the resources to improve the patient well-being. Despite the challenges experienced by the policy, recommendations such as evaluation of the EMTALA procedure to enhance the policy compliance will help minimize them.

References

Bernardo, W. (2017). Public health policies and scientific evidence. Einstein (São Paulo), 15(4), 7-10. Retrieved from https://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082017000400007&lng=en&tlng=en

Hughes, R. (2014). Patient Safety and Quality: An Evidence-Based Handbook for Nurses. AORN Journal, 90(4), 601-602. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK2651/

Miller, J. (2013). Professionalism interrupted? Professionalism’s challenges to local knowledge in New Zealand counselling. Current Sociology, 62(1), 100-113. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5468057/

Rosenbaum, S. (2014). The Enduring Role of The Emergency Medical Treatment and Active Labor Act. Health Affairs, 32(12), 2075-2081. Retrieved from https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2013.0660

Zhou, J., Amanatullah, D., & Frick, S. (2019). EMTALA (Emergency Medical Treatment and Active Labor Act) Obligations. Journal of Bone and Joint Surgery, 101(12), e55. Retrieved from https://journals.lww.com/jbjsjournal/Abstract/2019/06190/EMTALA__Emergency_Medical_Treatment_and_Active.12.aspx

Zibulewsky, J. (2014). The Emergency Medical Treatment and Active Labor Act (EMTALA): What It Is and What It Means for Physicians. Baylor University Medical Center Proceedings, 14(4), 339-346. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1305897/

Zuabi, N., Weiss, L., & Langdorf, M. (2016). Emergency Medical Treatment and Labor Act (EMTALA) 2002-15: Review of Office of Inspector General Patient Dumping Settlements. Western Journal of Emergency Medicine, 17(3), 245-251. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4899053/

Zuabi, N., Weiss, L., & Langdorf, M. (2018). Emergency Medical Treatment and Labor Act (EMTALA) 2002-15: Review of Office of Inspector General Patient Dumping Settlements. Western Journal of Emergency Medicine, 17(3), 245-251. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27330654/