Ask the expert: Why is it so difficult for hospitals to comply with EMTALA?
Medical Staff Leader Connection, June 10, 2009
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EMTALA is an unfunded federal mandate that requires hospitals to provide ED on-call services according to their available resources. Unfortunately, only physicians can fulfill this requirement, so hospitals are increasingly being asked to finance the shortfall between the payment physicians are entitled receive for providing emergency services and the actual payments—or lack thereof.
The Office of Inspector General recognizes that the federal government is cost shifting compensation for on-call services to healthcare organizations. Its recent finding that compensated arrangements at fair market value (FMV) represent a safe harbor is necessary to ensure that patients have access to emergency services.
It is sad to reflect that EMTALA has had the unintended impact of reducing access to emergency services. The root of the problem lies in the increasing uninsured and underinsured in America as a result of the inflationary costs of healthcare services and employers' inability to keep up with double-digit premium increases.
At minimum, the federal government should mitigate the regulatory and legal obstacles that may prevent hospitals from appropriately compensating physicians for legitimate services that are needed by the community and a legal obligation to provide.
This week’s question was answered by Jonathan Burroughs, MD, MBA, CMSL, senior consultant with The Greeley Company, a division of HCPro, Inc. in Marblehead, MA.
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