Guest guest Posted April 22, 2001 Report Share Posted April 22, 2001 There are extensive regulations implementing EMTALA and all sorts of advisory opinions as well as cases. A couple of notable cases that everyone should keep in mind. (For lots and lots of info do a google.com search on EMTALA.) 1. If something happens to a patient anywhere " ON YOUR CAMPUS " you must respond with a medical team from your facility and treat the patient appropriately. Calling EMS won't cut it. 2. A transferee hospital MUST report EMTALA violations, and not to do so is in itself a violation. 3. Any hospital attempting to get around EMTALA by calling EMS to respond to emergencies on it's campus is tempting fate in the form of stiff penalties. Any hospital attempting to set up a scheme to bill for services were done by EMS may be flirting with Medicare fraud, and if EMS is affiliated with the hospital, only one billing can occur for the same service. HCFA can be expected to be conducting more and more audits of hospitals and EMS firms to discover billing fraud, and some administrators will undoubtedly face federal prison time. Trust me. If you're a " Suit " and you're dirty, or even think you MIGHT be dirty, or if the thought of trying to play footsie around the rules has ever even flitted across your mind, seek legal help and guidance NOW. The FBI won't be impressed by your job title, salary, or bonuses for saving money for your institution. On the contrary, the agents who investigate you won't like you very much, particularly those assigned to white collar crimes, which category now occupies a very large portion of their investigative interests. Their tenacity grows in inverse proportion to the disparity between your earnings and theirs. (Of course, I hope everyone realizes that I'm discussing ADMINISTRATORS here, not gut level medics, unless the individual medics are part of a conspiracy and knowingly pad billing records as a part of a policy set forth by their employers.) Even then, they'll usually be given the opportunity to be a witness instead of a defendant. However, none of us can become complacent. Each and every EMT and Paramedic must be thoroughly familiar with the rules and be able to recognize questionable practices and avoid them. This will mean added emphasis on CE programs on these subjects. Gene Gandy E. Gandy, JD, LP EMS Professions Program Tyler Junior College Tyler, TX Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 22, 2001 Report Share Posted April 22, 2001 Why do you feel the law sucks. Frederick EMTALA , et.al., EMTALA is the Emergency Medical Treatment and Active Labor Act. It is a law passed by Congress and ratified by the President that says (in short) that once a patient comes to the ER, they MUST receive care from the ER regardless of their ability to pay. If the ER cannot provide appropriate care (say, they don't have a L & D department for the Active Labor patient, or a surgery for the trauma patient) they have to arrange transport to a facility capable of providing the care and stabilize the patient as best they can until that transport arrives. The law sucks, in my OPINION. Though I understand why it exists. Webb, LP FLW EMS, MO _________________________________________________________________ Get your FREE download of MSN Explorer at http://explorer.msn.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 22, 2001 Report Share Posted April 22, 2001 Actually you are somwhat incorrect EMTALA states that you must have an assessment by a qualified individual who has been designated by the institution, based on all capabilities of the institution. This law was brought about as a result of an OB patient in Tx who was turned away from a hospital as a result of a wallet biopsy being done and sent to the county hospital. If memory serves she delivered in the cab as a result of her bring sent away from the first hospital. Interesting part is that there is no unified definition of qualified person. Most hospitals believe that to be the ED Doc, however some are saying ER Triage nurse. Rinard <<< dfluffy01@... 4/22 10:42a >>> , et.al., EMTALA is the Emergency Medical Treatment and Active Labor Act. It is a law passed by Congress and ratified by the President that says (in short) that once a patient comes to the ER, they MUST receive care from the ER regardless of their ability to pay. If the ER cannot provide appropriate care (say, they don't have a L & D department for the Active Labor patient, or a surgery for the trauma patient) they have to arrange transport to a facility capable of providing the care and stabilize the patient as best they can until that transport arrives. The law sucks, in my OPINION. Though I understand why it exists. Webb, LP FLW EMS, MO _________________________________________________________________ Get your FREE download of MSN Explorer at http://explorer.msn.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 23, 2001 Report Share Posted April 23, 2001 " Why do you feel the law sucks? " Essentially, my complaint boils down to the fact that the federal government has created a social health system out of private providers, but is not paying the system enough to keep it running. Nationally we are in a crisis because the hospital can no longer say, " I'm sorry ma'am, we don't have L & D facilities here, you need to WALK ACROSS THE STREET to the hospital that does. We cannot push them across the street in a wheelchair. The hospital has to admit the patient (~$500) to the ED, check her out, 'stabilize' her, then call the hospital across the street and get an accepting physician, then call an ambulance to come drive the lady across the street (~$250) where she is again admitted to the hospital (~$500+++) to have her baby. We cannot make you sign an insurance waiver (a form that says you agree to pay if Medicare/Medicaid deny your claim). Even if you sign the form, you cannot be forced to pay without it costing the hospital even more. Look at it. It costs about $100 per hour to pay a lawyer. It will take at least 5 hours for the lawyer to draw up the paperwork to force you to pay. If your bill is less that $500, why waste the time? There is no guarentee you even have enough money to pay the bill. See the problem? Private insurance costs more and more, all the while paying for less and less. Hospital's cannot hire enough nurses due to the lack of ability to pay them well enough. Ambulance services cannot keep up with turn-over due to the lousy working conditions. Hospitals are closing. Ambulance services are closing. That doctor who did the 'taxi cab' study is going to get a chance to see if the taxi cab's really do just as well for patient survival as the ambulance soon...assuming he is still practicing in the ED. Anyhow, that is my beef with the law. It was well intended, but poorly implemented. Webb _________________________________________________________________ Get your FREE download of MSN Explorer at http://explorer.msn.com Quote Link to comment Share on other sites More sharing options...
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