EMTALA

EMTALA FAQ: Who can complaint about an EMTALA violation?19 November 2011

Anyone can file a complaint for an EMTALA violation against a hospital with the state hospital licensure folks or the federal CMS office. If found in violation, CMS will require them to file and successfully complete a plan of correction (allegation of compliance). Following that, the Office of Inspector General can fine them up to $50,000 per patient incident. If they fail to come into compliance, the hospital can be removed from the Medicare program, which effectively renders them bankrupt. If CMS finds that a physician violated EMTALA, in the fine process, OIG can also fine the physician or bar them from working anywhere that receives federal money. The money goes to the government.

In addition, any patient or patient legal representative or heir, depending on the state law for who has standing, can file a civil suit for violation of EMTALA against the hospital. If a physician is also to be named as a defendant, they must be sued under state malpractice law, not EMTALA, although violation of EMTALA may be alleged as evidence of malpractice since it is generally the prevailing law that shapes standard of care. Any money recovered goes to the patient.

In a little used aspect of the law, a hospital harmed by another hospital’s violation of EMTALA can file suit against the violating hospital — such as, hospital A refuses care to patient A because they are uninsured and Patient A goes to hospital B where they are admitted and run up substantial bills which they cannot pay. Hospital B can sue and recover payment from Hospital A for Patient A’s bills. Any money recovered goes to Hospital B. Hospital B can also seek an injunction against Hospital A to force them to comply with EMTALA.

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