Emtala

Since the development of the EMTALA Act in 1986, any individual which presents to the emergency department, must be accessed and triaged by qualified medical personnel. (www.cms.gov) Individuals are aware that if they present to the emergency department, regardless if it is for just a tooth ache or a major illness like a heart attack, they will have to be treated. “This mandate does not extend to private physician offices, however, which creates an incentive for those without the means to pay for care to

In 1986, the Emergency Medical Treatment and Labor Act (EMTALA) was enacted. The federal government enacted the law to provide everyone with access to emergency medical care, even for those unable to pay. EMTALA declared that any individual who enters a “qualifying hospital” is entitled to an “appropriate” medical examination to determine if an “emergency medical condition” is present. The individual cannot be “transferred” until the “emergency medical condition” is “stabilized.” Only if the individual cannot be “stabilized,” an “appropriate transfer” may be performed. Hospitals must accept

The Emergency Medical Treatment and Active Labor Act (EMTALA) was enacted in 1986 as a part of the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985. EMTALA was enacted to prevent hospitals with Emergency Departments from refusing to treat or transferring patients with emergency medical conditions (EMC) due to an inability to pay for their services. This act also applies to satellite locations whom advertise titles such as “Immediate Care” or “Urgent Care,” and all other facilities where one-third of their patient intake are walk-ins. Several rules and regulations to this act have been established and it has become a very serious piece of legislation and health

A variety of data will be required to test the theory of effectiveness being employed. Firstly, data will be required regarding incidences where in EMNC could be faced with lawsuits ranging from: patient negligence to a, failure to protect nursing staff and other health care workers from injury. Other data will come from the literature on health care giver standards that have been shown to help avoid lawsuits, (e.g. failure to use equipment in a responsible manner, failure to communicate, failure to document patient care and failure to act as a patient advocate).

On March 23, 2010, the Affordable Care Act (ACA) or “Obamacare” was signed and put into effect (DiMichele, 2017). From then to now, many people in the United States are split from fully agreeing to completely against this certain reform. Throughout different types of research and speaking to an interviewee, I have found multiple reasons that the ACA is good and why it can be bad (or Pros and Cons). One important pro that I found was that with Obamacare, anyone can have the choice of their own Physician or place of care for their needs, then just being able to get care from an Emergency Room (ASPA, 2015). This lets the patient have more freedom to make their own decisions based on their own healthcare and what they

Another issue is immigrants using emergency care instead of preventative care. The Federal Emergency Medical Treatment & Active Labor Act (EMTALA) states that hospitals with emergency rooms

The Obamacare/ACA, might have helped numerous of individuals in acquiring health care, but the health professionals are facing a shortage of reimbursement difference for their services. As a result, Hospitals and healthcare providers were force to layoff personal and come up with innovative solutions. This point is proven by the renowned author, Amy Anderson by stating as follows: “The American health care framework has had shortages of personnel for quite some time and would not be prepared to give the adequate service to this amount of patients in need of medical attention. Training new professional health services personnel could take years. There is a shortage of graduates from medical and nursing schools. Doctors, nurses and health professional are sharing responsibilities prospective patients will face a longer wait time”. (Anderson, 2014)

The ACA was created to help insure a larger portion of the nation’s population and give people access to affordable and higher quality care. Unfortunately, the ACA completely excludes undocumented immigrants from the eligibility of the program, even though this population consists of 11 million, which is a huge chunk of the nation’s population. As a result, the undocumented population is left with Emergency Medicaid, which is a program that is a part of ACA. This program gives some limited assistance to undocumented individuals in a case of an “emergency” or pregnancy related issues. Emergency Medicaid does not cover any type of prevention care or offer primary physicians to patients. It is also important to note that if the hospital determines that the visit was not an emergency, then the patient is left with a high medical bill that they would not be able to afford possibly leading to bankruptcy.

The case of Marie Moses-Irons vs. Providence Hospital. Johnella Richmon Moses representative of the estate of Marie Moses-Irons (deceased) brought a case of an EMTALA violation and other negligence accusations to the U.S District Court on December 14, 2002. The lawsuit was against the Providence Hospital and Medical Centers, Inc. and Dr. Paul Lessem. On December 13, 2002, Marie Moses-Irons brought her husband, Christopher Howard, to the emergency department of Providence Hospital in Southfield, Michigan due to severe headaches, muscle soreness, high blood pressure, vomiting, slurred speech, hallucination, and delusional statements. The patient was admitted to the hospital’s emergency room and was treated for the physical complaints as well for the psychiatric problems. Dr. Lessem treated Christopher Howard during the hospital stay and

One of the primary goals of the Affordable Care Act (ACA) was to provide affordable health care coverage and increase access to affordable health care to the community. Unfortunately, since the passage of the ACA, while there has been an increase in the number of people with health care coverage, those same people do not necessarily have access to affordable health care. Currently, the public views the Emergency Department (ED) as a safety net by the community it serves; as demonstrated by the increasing number of people who continue to seek treatment in the ED for non-urgent problems. Utilization of the ED for non-urgent care contributes to the rising costs of healthcare as treatment in this setting can be upwards of three times the cost

In the first quarter of 2016 the Patient Protection and Affordable Care Act (PPACA) legislation has lead to 20 million Americans gaining healthcare coverage, and a record low uninsured rate of 8.6 percent (U. S. Department of Health & Human Services [DHHS], 2016). Yet the verdict is out on whether the PPACA has been an improvement or a liability holding back the United States (US) healthcare system’s potential. The legislation was first integrated as a guide to the US healthcare system when it was signed by President Barack Obama on March 23, 2010 (Rosenbaum, 2011). It planned to fulfill goals of improving access, affordability, and quality in healthcare (U. S. Department of Health & Human Services [DHHS], 2015). Full implementation of the healthcare reform was established on January 1, 2014, marking the start of individual and employer responsibility provisions, state health insurance exchanges, Medicaid expansions, and individual and small-employer group subsidies (Rosenbaum, 2011). As a whole the PPACA intended to “reframe the financial relationship between Americans and the health-care system to stem the health insurance crisis that has enveloped individuals, families, communities, the health-care system, and the national economy” (Rosenbaum, p. 131, para. 2). While the legislation has not fully

(TCO 1) How could a hospital legally avoid being covered by the Emergency Medical Treatment and Labor Act (EMTALA)?

The rising costs of unpaid emergency room expenditures were an issue that had to be addressed by state authorities. EMTALA required that all persons be treated, however, it did not include any legislation to reimburse payment that left hospital left with unpaid bills and growing expenses.

“Hospitals are not only required to care for emergency patients, but they also are required to do so in a timely fashion” (Pozgar, 2010, p. 272). “Hospitals are expected to notify specialty on-call physicians when their particular skills are required in the emergency department. An on-call physician who fails to respond to a request to attend a patient can be liable for injuries suffered by the patient because of his or her failure to respond” (Pozgar, 2010, p. 271). Under the doctrine of Respondeat Superior, hospitals are also liable for the actions of physicians working or on-call in their emergency department.

Case management in the emergency department, constantly works to find the right data in a patient’s record to ensure that they have the correct insurance coverage and can be admitted or discharged at the appropriate time and place. Even when the smallest amount of essential information is not documented, this otherwise straight forward process turns into a scavenger hunt for who has seen the patient, interventions that were done and for what reasons, and at what time all of these things took place. ED case manager Veronica Kountz (personal communication, March 20, 2015) states that the inadequacy of documentation can lead to insurance companies not covering patient costs, which the hospital then has to absorb. Before a patient can be admitted or discharged, the right