Waiving EMTALA sanctions in response to public health emergencies

Biosecurity and Bioterrorism

Volumn 6, Issue 3, 2008, Pages 213-217

  Courtney, Brooke ^a  

^a UNIVERSITY OF PITTSBURGH MEDICAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; EMERGENCY HEALTH SERVICE; HEALTH CARE DELIVERY; HUMAN; LEGAL ASPECT; MASS DISASTER; UNITED STATES;

EMERGENCY MEDICAL SERVICES; HEALTH SERVICES ACCESSIBILITY; HUMANS; MASS CASUALTY INCIDENTS; UNITED STATES;

EID: 52149084142     PISSN: 15387135     EISSN: None     Source Type: Journal    
DOI: 10.1089/bsp.2008.0825     Document Type: Article

References (26)

1. 42 U.S.C. § 1395dd (2008).
2. Centers for Medicare and Medicaid Services. EMTALA: Overview. April 17, 2006. http://www.cms.hhs.gov/EMTALA/. Accessed August 19, 2008.
3. 42 U.S.C. § 1320b-5 (2008).
4. See, eg, Kamoie B. EMTALA: dedicating an emergency department near you. J Health Law 2004;37(1):41-60.
5. Centers for Medicare and Medicaid Services. State Operations Manual: Appendix V - Interpretive Guidelines - Responsibilities of Medicare Participating Hospitals in Emergency Cases (Rev. 1, 05-21-04). http://www.cms.hhs.gov/manuals/Downloads/som107ap_v_emerg.pdf. Accessed August 19, 2008.
6. Rosenbaum S, Kamoie B. Finding a way through the hospital door: the role of EMTALA in public health emergencies. J Law Med Ethics 2003;31(4):590-601.
7. After the 2001 anthrax attacks, hospitals sought clarification from CMS about their EMTALA obligations if their staff encountered situations related to actual or potential biological agent exposure. CMS replied that all hospitals must meet their EMTALA obligations. However, the agency also stated that a hospital's transfer or referral of potentially exposed patients prior to the actual examination in accordance with a community response plan that designates specific facilities to handle certain categories of patients in bioterrorism situations would not violate its EMTALA obligations. Centers for Medicare and Medicaid Services. Question and answer relating to bioterrorism and the Emergency Medical Treatment and Labor Act (EMTALA) (Ref: S&C-02-04). November 8, 2001.
8. The Public Health Security and Bioterrorism Preparedness and Response Act of 2002 gave the HHS Secretary the authority under section 1135 of the Social Security Act to temporarily waive EMTALA sanctions "for a transfer of an individual who has not been stabilized . . . if the transfer arises out of the circumstances" of a national emergency. The language did not affect the obligations of hospitals to conduct medical screening examinations. Public Health Security and Bioter-rorism Preparedness and Response Act of 2002. Pub. L. No. 107-188; see also, Rosenbaum and Kamoie (2003).
9. Personal communication, Centers for Medicare and Medicaid Services staff, June 23, 2008.
10. Centers for Medicare and Medicaid Services. Center for Medicaid and State Operations/Survey and Certification Group. Waiver of Emergency Medical Treatment and Labor Act (EMTALA) sanctions in hospitals located in areas covered by a public health emergency declaration (Ref: S&C-08-05). December 7, 2007 (revised December 14, 2007).
11. 42 C.F.R. 489.24(a)(2) (2008).
12. Pandemic and All-Hazards Preparedness Act. Pub. L. No. 109-417 (2006).
13. Hoffman S. Responders' responsibility: liability and immunity in public health emergencies (Working Paper 07-29). Case Research Paper Series in Legal Studies August 2008.
14. Ransom MM, Goodman RA, Moulton AD. Addressing gaps in health care sector legal preparedness for public health emergencies. Disaster Med Public Health Prep 2008;2(1):50-56.
15. Emergency Medical Treatment and Labor Act Technical Advisory Group. Report Number Five to the Secretary U.S. Department of Health and Human Services from the Emergency Medical Treatment and Labor Act Technical Advisory Group. November 2-3, 2006.
16. U.S. Department of Health and Human Services. The Secretary of Health and Human Services. 2005 Hurricane Season: HHS declares public health emergency for Hurricane Katrina. Waiver under Section 1135 of the Social Security Act. September 4, 2005. http://www.hhs.gov/katrina/ssawaiver.html . Accessed March 17, 2008.
17. U.S. Department of Health and Human Services. The Secretary of Health and Human Services. Waiver under Section 1135 of the Social Security Act. September 7, 2005.
18. U.S. Department of Health and Human Services. The Secretary of Health and Human Services. Waiver under Section 1135 of the Social Security Act. September 23, 2005. http://www.cms.hhs.gov/Emergency/Downloads/1135waiverundertheSSA.pdf.
19. U.S. Department of Health and Human Services. The Secretary of Health and Human Services. Waiver or Modification of Requirements under Section 1135 of the Social Security Act. August 19, 2007. http://www.hhs.gov/disasters/ emergency/naturaldisasters/hurricanes/deanleavit1135waiver.pdf.
20. U.S. Department of Health and Human Services. Office of the Secretary. Waiver or Modification of Requirements under Section 1135 of the Social Security Act. June 14, 2008. http://www.cms.hhs.gov/Emergency/Downloads/ Indiana1135Waiver.pdf.
21. U.S. Department of Health and Human Services. Office of the Secretary. Waiver or Modification of Requirements under Section 1135 of the Social Security Act. June 14, 2008. http://www.cms.hhs.gov/Emergency/Downloads/Iowa1135Waiver. pdf.
22. Centers for Medicare and Medicaid Services. Center for Medicaid and State Operations/Survey and Certification Group. Survey and certification issues related to Iowa and Indiana flooding disasters (Ref: S&C: 08-27). June 17, 2008.
23. Iowa Department of Inspections and Appeals. Hospitals not subject to certain EMTALA violations during emergency. June
24. 2008. http://dia.iowa.gov/EMTALA%20Waiver%20Hot%20Notice.pdf.
25. This issue has been considered by the Centers for Medicare and Medicaid Services EMTALA Technical Advisory Group (TAG), which was convened by HHS "to gather input on how revised regulations and enforcement are working in practice." Emergency Medical Treatment and Labor Act Technical Advisory Group. Final Report of the Emergency Medical Treatment and Labor Act Technical Advisory Group to the Secretary U.S. Department of Health and Human Services. April 2, 2008.
26. This issue was recommended as a high priority by the Centers for Medicare and Medicaid Services EMTALA Technical Advisory Group (TAG). Specifically, the TAG recommended "that HHS pursue statutory and regulatory changes, as well as changes to the Interpretive Guidelines, addressing waiving EMTALA obligations in an emergency as declared by a Federal, State, county, or city government or by an individual hospital." Emergency Medical Treatment and Labor Act Technical Advisory Group. Extract of the Final Report of the Emergency Medical Treatment and Labor Act Technical Advisory Group to the Secretary U.S. Department of Health and Human Services. April 2, 2008.