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CMS clarifies Emergency Services Conditions of Participation

Case Management Weekly, May 2, 2007

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Most Medicare-participating hospitals are required to be able to evaluate and provide initial treatment to anyone with an emergency, CMS clarified in a memo to state survey agency directors last week.

The memo reminder comes a month after a Texas patient died after a physician-owned specialty hospital dialed 911 to transfer him to another facility instead of providing treatment.

Medicare Conditions of Participation require that hospitals, regardless of whether they have dedicated EDs, be able to appraise and initiate treatment in emergency situations, as well as arrange for a referral or transfer to another facility when appropriate.

"Any hospital participating in Medicare, regardless of the type of hospital and apart from whether the hospital has an emergency department must have the capability to provide basic emergency care interventions," CMS acting Administrator Leslie V. Norwalk said in a press release. "The guidance we are issuing is part of an overall strategy to ensure quality care by assuring the rapid response to emergencies for all people with Medicare."

Source: Bureau of National Affairs; CMS

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