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In a time of true medical need, the last thing you should have to worry about is how to pay for your care and treatment.  In order to help ensure patients get emergency medical care even when they can’t pay for it, Congress pass the Emergency Medical Treatment and Active Labor Act (EMTALA) in 1986.  Under EMTALA, hospitals that receive Medicare funds and provide emergency services are required to conduct an examination of, provide stabilizing treatment for, and appropriately transfer a patient with a medical emergency or who is in active labor, regardless of the patient’s ability to pay.   Failure to comply can result in the hospital being fined or even losing its Medicare funding.

Thirty Years Later, Hospitals Still Dumping Patients

Although EMTALA has undoubtedly improved the level of care provided to the neediest patients, many hospitals still try to circumvent the rules.  Vulnerable populations, such as homeless, uninsured, or mentally ill patients, are often transferred or denied care in violation of EMTALA.  For-profit hospitals seem to be more likely to dump patients than others.  Violations mean serious sanctions, but only if the offending hospital gets caught.  Civil liability for violations of EMTALA is also available, but some jurisdictions require victims and families to meet an almost impossible burden of proving gross negligence or intentional misconduct.

Continuing Care Falls Short

Even after a medical emergency is over, many patients need ongoing care and treatment to truly address their problem.  In Los Angeles, many patients with serious chronic conditions are discharged (often to the street) after acute episodes only to return shortly.  The problem isn’t limited to California, as complaints are made from coast to coast.  And while the cost of ongoing care is certainly expensive, stopgap solutions only create a revolving door of patients receiving less-than-definitive care.

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