New Hospital Interpretive
Guidelines and State Operations Manual Revisions
PDF Version
of BQA 98-038 (PDF, 5 KB)
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Date: September 2, 1998 DSL-BQA 98-038
To: Hospitals HOSP - 14
From: Judy Fryback, Director, Bureau of Quality Assurance
Attached is a copy [not included for Internet viewers] of
the new Hospital Interpretive Guidelines and State Operations Manual Revisions from the
Health Care Financing Administration for EMTALA (the Emergency Medical Treatment and Labor
Act which is also known as "the anti-dumping regulations".
Briefly, EMTALA applies to hospitals that
participate in the Medicare program and offer emergency services. The law applies to all
patients who come to the hospital seeking emergency care, not just those who are Medicare
beneficiaries. The law requires hospitals to do three basic things: 1) the hospital must
provide an appropriate medical screening examination to determine if the patient really
has a medical emergency; 2) if an emergency condition exists, the hospital must provide,
within its capability, whatever treatment is necessary to stabilize the emergency
condition; and 3) the hospital may not transfer a patient in an unstabilized emergency
condition to another facility unless the patient requests the transfer, or a physician
certifies that the benefits of the transfer outweigh the risks.
"Section 3400, Background" updates instructions
and policy interpretation for conducting a complaint investigation under the auspices of
42 CFR 489.20 and 489.24 based on recent recommendations by the State survey agencies,
HCFA regional offices, and the Department of Health and Human Services (HHS), Office of
Inspector General (OIG). "Appendix V, Interpretive Guidelines and Investigative
Procedures for Responsibilities of Medicare Participating Hospitals in Emergency
Cases" updates interpretive guidelines based on recent recommendations by the State
survey agencies, DCFA regional offices, the Department of Health and Human Services (HHS),
and the Office of the Inspector General (OIG).
The new Guidelines and revisions will be implemented and
effective as of July 14, 1998. HCFA Publications are also obtainable via the HCFA Internet
site at: http://www.hcfa.gov/pubforms/pubforms.htm
(exit DHFS) [address updated]
Please share this information with the appropriate staff
and direct any questions that you may have to Beth Stellberg, Chief, Health Services
Section (replaced by Cremear Mims).
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