EMTALA Covid-19 Waiver
CMS Frequently Asked Questions – Coronavirus – EMTALA Covid-19 Waiver
Robert A. Bitterman, MD, JD, FACEP
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TAKE-HOME: Most existing emergency department (ED) EMTALA requirements are still in place during the Coronavirus pandemic, including the requirement to screen and stabilize every individual who presents to the ED, and to accept transfers from hospitals that lack the necessary capability or capacity to stabilize patients with emergency conditions, including Covid-19. Hospitals are now allowed to direct patients off-site for Covid-19 screening.
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New CMS Guidance on Coronavirus – FAQs
On April 28th, the Centers for Medicare and Medicaid Services (CMS) issued Frequently Asked Questions related to Coronavirus. The CMS FAQs are available at https://www.cms.gov/files/document/frequently-asked-questions-and-answers-emtala-part-ii.pdf.
The only substantive change was to allow hospitals to direct patients away from the ED to an off-campus location for screening.
In spite of this waiver, most hospitals are still screening Covid-19 patients on campus.
The new FAQs are intended to more fully explain the March 9th and March 30th CMS guidance related to Coronavirus.
(see EMTALA-Coronavirus-COVID-19).
The March 9th CMS memo is available at https://www.cms.gov/files/document/qso-20-15-hospitalcahemtala.pdf and the March 30th revision is available at https://www.cms.gov/files/document/qso-20-15-hospital-cah-emtala-revised.pdf. ACEP’s summary of the CMS’s EMTALA Coronavirus guidance is available at https://www.acep.org/globalassets/summary-of-covid-19-emtala-guidance.pdf
Two important caveats remain:
- Whatever screening process the hospital establishes on- or off-campus must be based on medically indicated criteria and provided to all comers on a non-discriminatory basis.
- The hospital must still maintain a log of all patients presenting to the ED, in the same manner prescribed by CMS regulations for the ED itself.
Please contact our office if you have specific EMTALA legal questions. Our healthcare attorneys are standing by to assist you.