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Re: EMTLA

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Unfortunately, , the law is administered by the Health Care Finance

Administration (HCFA) and common sense has NOTHING to do with it.

The rulings on the EMTALA are available on a variety of websites, and I would

ask everyone to take a little time and read some of these things. You'll

find out that the 250 foot rule may be stretched to a mile or more if the

hospital " campus " goes that far. And a call to 911 cannot normally be

substituted for the requirement that the hospital actually respond with a

team from its ER. That has led many hospitals to purchase golfcart EMS

vehicles and outfit them with all the bells and whistles. It may be that

it's appropriate for EMS to respond and transport, but hospital personnel,

including physicians, must journey to the patient and conduct the proper

assessment and treatment.

If a provider has questions about its particular situation, it should request

an opinion letter from HCFA; however, like the IRS, HCFA is not bound by its

own opinions, which are deemed to be advisory only. Their positions can

change with the wind, and there may be regional differences in

interpretation. So questions about EMTALA rulings need to be addressed by

legal counsel, preferably those who are knowledgeable about these rules,

which are extremely complicated.

HCFA will work with people to find solutions, but unless they are working

with you at the time a violation comes to their attention, you're pretty much

dead meat. At least in for a long and expensive siege in the administrative

process and perhaps even into federal court. It would be easy to spend

$200,000 or more in legal fees defending one action.

Gene

E. Gandy, JD, LP

EMS Professions Program

Tyler Junior College

Tyler, TX

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