Emergency Medical Treatment and Active Labor Act
The Emergency Medical Treatment and Active Labor Act (42 U.S.C. § 1395dd, EMTALA) is a United States Act of Congress passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act. It requires hospitals and ambulance services to provide care to anyone needing emergency treatment regardless of citizenship, legal status or ability to pay. There are no reimbursement provisions; as a result of the act, patients needing “emergency” treatment can be discharged only under their own informed consent or when their condition requires transfer to a hospital better equipped to administer the treatment. EMTALA applies only to “participating hospitals” which accept payment from the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) under the Medicare program. In practical terms, it applies to virtually all hospitals in the U.S., with the exception of the Shriners’ Hospital for Crippled Children, Indian Health Services and military VA hospitals. Its provisions apply to all patients, and not just to Medicare patients. [1] [2] The combined payments of Medicare and Medicaid, $602 billion dollars in 2004[6] or roughly 40% of all medical expenditures in the United States, make not participating in EMTALA impractical for nearly all hospitals.
