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EMTALA: Understand the regulations before you audit

Healthcare Auditing Weekly, December 16, 2003

Before you audit your organization's compliance with the Emergency Medical Treatment and Labor Act (EMTALA), make sure you understand the regulation, including all the changes the Centers for Medicare and Medicaid Services (CMS) made in September. The deadline for complying with these changes was November 10, 2003.

Here is an overview of the changes:

·  Clarifies that outpatient clinics that do not routinely provide emergency care are not obligated by EMTALA

·  Clarifies that hospitals aren't required to provide around-the-clock coverage in every specialty-they may develop their on-call list to best meet the needs of their communities

·  Permits physicians to be on call simultaneously at more than one hospital and to schedule elective surgery and other medical procedures during on-call time

·  Requires hospitals to wait until the patient has been screened and stabilized before requesting insurance authorization from the patient's insurer

For more information on how to apply the "anti-dumping" statute, its interpretive guidelines, and the final changes released by CMS in September 2003, order the book "A Practical Guide to EMTALA Compliance." This book also includes step-by-step advice on how to respond to an EMTALA violation, a sample EMTALA audit plan, realistic scenarios that illustrate how to comply with EMTALA in various situations, an informative Q&A section to help you meet EMTALA's on-call requirements and ensure that your facility complies with EMTALA, information on how to train employees on EMTALA, appendices that offer a glossary that explains key terms and points you to applicable page numbers in the final rule, directions that CMS gives to surveyors on how to investigate a potential violation.

On the accompanying CD-ROM, you'll receive customizable and downloadable training section that gives you guidance on how to train employees and what information to cover, one hospital's 40-page training presentation, a training quiz with answer key to help you reinforce and document training, and the complete EMTALA final rule. Just click here for more information or to order.

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