The Emergency Medical Treatment and Labor Act (EMTALA) was passed in 1986 under the Reagan administration to help prevent patient dumping. The law requires hospitals to provide emergency medical treatment to anyone regardless of citizenship, legal status or ability to pay. In recent years however hospitals have begun to impose upfront emergency room fees. Today approximately half of all hospitals do so. Hospital executives claim these fees reduce ER overcrowding by diverting patients with non-emergency needs. Patient advocates claim the fees undermine EMTALA's intent and causes patients' health conditions to worsen. For example, in 2011 one large national hospital chain saw 80,000 patients leave their emergency rooms untreated when faced with a $150 use fee.
During this 17 minute podcast Professor Rosenbaum explains what generally EMTALA requires, when ER fees can be legally solicted or collected, the negative effects of fee collection, she questions the legitimacy of the industry's argument that fees help to encourage more appropriate site of care use and what can be done to provide better oversight and enforcement of EMTALA.
Professor Sara Rosenbaum is the Harold and Jane Hirsh Professor of Health Law and Policy and Founding Chair of the Department of Health Policy at The George Washington University School of Public Health and Health Services. Professor Rosenbaum is best known for her work on the expansion of Medicaid and community health centers, patients' rights in managed care, civil rights and health care, and national health reform. She is the lead author of Law and the American Health Care System, a landmark textbook that provides an in-depth exploration of the interaction of American law and the U.S. health care system. She has received numerous national awards for her work, serves on governmental advisory committees, private organizational and foundation boards, and is a past Chair of AcademyHealth. She is a member of the CDC Director's Advisory Committee, the CDC Advisory Committee on Immunization Practice and a Commissioner on the Medicaid and CHIP Payment and Access Commission (MACPAC). She received her BA from Wesleyan and her JD from Boston University.
Will An Emergency Room Really Treat Everyone Regardless of Their Ability to Pay?: A Conversation with Sara Rosenbaum (January 16, 2014)