A 30 year old man who walked into a Bronx hospital emergency department Sunday night was found dead Monday morning before he could see a physician. His presenting complaint was for a “rash” and the exact cause of death has not been released. The New York Daily News reports that employees blamed the death on … Read more
FILE: 11-004 DATE: November 10, 2011 STATE: California TAG: A2405 TITLE: Emergency Room Log ALLEGED VIOLATION: On 11/9/11 review of the EMTALA complaint and interviews with ED staff confirmed Basic Life Support (BLS) EMT personnel brought Patient 8 to the ED by ambulance on 12/17/10. The EMT personnel had been directed to the nearest hospital … Read more
QUESTION: Is the sample scoring tool and policy on this site a mandated EMTALA compliance form? Our Obstetricians don’t like some of the provisions. COMMENT: CLICK HERE FOR REFERENCED FORM) ANSWER: The OB scale was created using scales in use at several hospitals at the time and published standards. Originally it was assembled by my … Read more
ACEPNOW.COM has published a new article echoing and expanding on a previous Medlaw.com warning that signs announcing a limitation on pain medications in the ED violate a 2013 advisory from CMS. EDs have continued to post the signs in reliance on endorsements by various groups, including state ACEP chapters, often believing the signs comply with … Read more
FILE: 11-003 DATE: January 24, 2011 STATE: Arkansas TAG: A2405 TITLE: Emergency Room Log ALLEGED VIOLATION: Based on review of the Emergency Department Log, Medical Staff Rules and Regulations, Policy and Procedure GO18 EMTALA (Emergency Medical Treatment and Labor Act) Medical Screening/Stabilization and interview, it was determined the facility failed to ensure every patient presenting … Read more
FILE: 11-002 DATE: October 7, 2011 STATE: Alabama TAG: A 1103 TITLE: Integration of Emergency Services ALLEGED VIOLATION: Based on hospital rules and regulations, hospital policy, emergency department (ED) medical record reviews, and interviews, the hospital (Hospital # 1) failed to assure that ED patients receive services integrated with other departments and cardiac specialists (who … Read more
Starting with this article, we will be publishing actual EMTALA citations as examples of real-world enforcement. These examples are excerpted from my next book EMTALA Enforcement that I hope to have ready for release before April of this year. FILE: 11-001 DATE: January 20, 2011 STATE: Alabama TAG: A2405 TITLE: Emergency Room Log ALLEGED VIOLATION: … Read more
So what about folks with co-pays and large deductible policies? With insurance companies cancelling millions of policies and employers reducing coverage in many instances or cutting folks back to part-time to avoid Obamacare, many of your ED “insured” visits will be severely under-insured and might not even realize that they are going to have to … Read more
What about other plan restrictions? CMS comments included: Payors restricting the number of consults that will be paid for during a hospital encounter/stay, including the use of consults for completing an MSE or providing stabilizing treatment of EMCs. Hospitals must not assume that such a coverage limitation by one or more payors would allow them … Read more
What if the plan looks at the final diagnosis codes and decides not to pay? Payor refusal to pay for emergency department (ED) services because the payor views the diagnosis codes on the hospital’s bill to the payor as representing conditions that are “non-emergent”. In States where such payor practices have been under discussion, some … Read more