How to Report an EMTALA Violation
Emergency Medical Treatment and Active Labor Act (EMTALA) is a federal law that aims to ensure individuals receive prompt and adequate emergency medical treatment, regardless of their insurance status. To achieve this, EMTALA imposes certain requirements on hospitals and other emergency healthcare providers. However, violators can face significant legal and financial consequences.
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What Constitutes an EMTALA Violation?
EMTALA violations occur when an emergency healthcare provider fails to provide timely and adequate treatment to an individual who requests emergency services or is under 42 U.S.C. §1395dd (b) in an emergency department or under 42 U.S.C. §1395dd (e) in another setting.
Some common types of EMTALA violations include:
• Denied or delayed treatment: The hospital fails to provide prompt medical treatment, or an individual is left in an ambulatory or emergency care department for an unreasonable period.
• Failure to identify and treat emergency conditions: The healthcare provider fails to identify or treat emergency medical conditions, such as stroke or heart attack, in a timely and adequate manner.
• Failure to perform a screening examination: The hospital or healthcare provider fails to conduct a thorough medical screening examination to identify possible emergency medical conditions.
• Refusal of medical screening or treatment: The individual is denied a medical screening examination or treatment because they lack health insurance or payment.
Reporting an EMTALA Violation
Who Can Report an EMTALA Violation?
- Healthcare providers: Healthcare providers can report an EMTALA violation by their peers, including hospital staff, healthcare organizations, or other entities.
- Patients: Patients who believe they were subjected to an EMTALA violation can report it to the appropriate authorities.
When to Report an EMTALA Violation
Report an EMTALA violation as soon as possible, ideally within 72 hours of the alleged violation. Extension of this time limit can be requested by filing a request with the Inspector General of the U.S. Department of Health and Human Services (HHS).
Where to Report an EMTALA Violation
Medicaid and State Medicaid Agency Offices
Contact your local Medicaid and State Medicaid Agency Office for any EMTALA violation regarding Medicaid-covered services. Their contact information can be found on the Centers for Medicare & Medicaid Services (CMS) website.
United States Department of Health and Human Services (HHS)
Report an EMTALA violation to HHS if you believe a hospital or healthcare provider is violating EMTALA provisions. Contact them at:
- Address: 200 Independence Avenue, SW, Washington, D.C. 20201
- Phone: (202) 619-0403
- Fax: (202) 619-0401
Local and State Governments
File a complaint with your local and state Health Departments or Attorney General’s Offices for EMTALA violations regarding non-Medicaid-covered services.
What to Report When Submitting an EMTALA Violation?
Details of the Incident
When reporting an EMTALA violation, provide the following information:
• Patient information: Name, contact information, and a summary of their medical condition
• Date and time of incident: Specify the date and time when the alleged violation occurred
• Location: Identify the emergency department, hospital, or healthcare facility where the violation occurred
• Services denied or delayed: Outline the services that were allegedly denied or delayed
• Supporting Documentation: Attach relevant medical records, test results, or statements from witnesses or medical providers
Additional Information
Provide additional information that might be helpful in investigating the EMTALA violation:
• Reasons given for denial or delay: If you were informed that services were denied or delayed, write down the reason given by the healthcare provider
• Patient outcomes: Outline any subsequent consequences or complications that occurred due to the alleged EMTALA violation
Filing a Complaint Form
Use a standard form or create your own report outlining the details of the EMTALA violation. Some hospitals or healthcare providers may also have an internal reporting system for EMTALA violations.
Table: Contact Information for Reporting EMTALA Violations
| Agency/Office | Address | Phone | Fax | |
|---|---|---|---|---|
| CMS | www.cms.gov | (404) 498-4538 | (410) 786-6561 | cms-hospitalsurvey@hcfi.com |
| HHS | 200 Independence Avenue, SW, Washington, D.C. 20201 | (202) 619-0403 | (202) 619-0401 | ose@hhs.gov |
In conclusion, reporting an EMTALA violation is essential to ensuring that healthcare providers adhere to the law’s requirements. By providing specific details of the incident and supporting documentation, individuals can help initiate an investigation into alleged violations.
