EMTALA Requirements and the Medical Screening Exam
Medicare participating hospitals must meet the Emergency Medical Treatment and Labor Act (EMTALA) statute codified at §1867 of the Social Security Act, (the Act) the accompanying regulations in 42 CFR §489.24 and the related requirements at 42 CFR 489.20(l), (m), (q), and (r). EMTALA requires hospitals with emergency departments to provide a medical screening examination to any individual who comes to the emergency department and requests such an examination, and prohibits hospitals with emergency departments from refusing to examine or treat individuals with an emergency medical condition (EMC).
The Medical Screening Exam is a key component of EMTALA compliance. All patients shall receive a medical screening exam (MSE) that includes providing all necessary testing and on-call services within the capability of the hospital to reach a diagnosis. Federal law requires that all necessary definitive treatment will be given to the patient and only maintenance care can be referred to a physician office or clinic.
Key points for hospitals to focus on with regards to EMTALA medical screening exam compliance include:
- Medical screening exams and/or stabilizing treatments may not be delayed in order to inquire about payment status.
- The medical screening exam needs to be suitable for/address the symptoms presented and conducted in a nondisparate fashion.
- The hospital is required to determine who is qualified to conduct the medical screening exam, i.e., the qualified medical person.
- Non-physician practitioner(s) may be designated as the qualified medical person so long as the designated non-physician practitioner(s) are identified in a document that is approved by the governing body of the hospital. Those health practitioners designated to perform medical screening examinations are to be identified in the hospital by-laws or in the rules and regulations governing the medical staff following governing body approval.
Included with today’s notice is an example EMTALA Medical Screening Exam policy.
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