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Emergency Medicine Treatment and Labor Act

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Emergency Medicine Treatment and Labor Act, EMTALA

  • Background
  1. Emergency Medicine Treatment and Labor Act (EMTALA) was Enacted in U.S. in 1986 as part of COBRA
  2. Ensures access to emergency services regardless of ability to pay
  3. Applies to most hospitals in the United States (those that accept CMS payment)
  • Criteria
  1. Includes an emergency medical screening to determine if a medical emergency exists
  2. Defines obligations regarding medical stabilization, appropriate transfer, and active labor
    1. Medical providers must do their best, in line with their training, to stabilize the patient
    2. When higher level of care is required
      1. Sending provider is responsible for identifying most appropriate accepting facility and transport mode
      2. Sending provider is responsible for the patient until they arrive at the destination facility
      3. Accepting provider must determine if receiving hospital has needed resources, and may provide expert Consultation
      4. Accepting facility can not make their acceptance contingent on the use of their CCT
  3. Ravenswood Rule (250 yard rule)
    1. Required to respond within 250 yards of the main hospital campus building to medical emergencies
    2. Exception (2010): Helipad emergencies if not receiving hospital (unless help requested by EMS or patient)
  • References
  1. Aydin, Fritz, Duncan and Cohen (2022) Crit Dec Emerg Med 36(10): 23-29