EMTALA - Covering Emergency Call Through Community Plans
On July 31, 2008, the Centers for Medicare and Medicaid Services (CMS) released its FY 2009 final rule for the Inpatient Prospective Payment System. Included with in the manyy regulatory changes contained in this final rule are new provisions regarding the requirements of the Emergency Medical Treatment and Active Labor Act (EMTALA). Among these are new rules for hospitals to develop "community on-call plans" as a means of meeting their on-call services obligations under EMTALA.
The new rules allow for two or more hospitals to collaberate to develop a community on-call coverage plan that applies within a specific geographic area and divides the coverage of certain types of services between the participating hospitals at designated times. Specifically, a formal community on-call plan among a group of hospitals needs to include:
- A clear delineation of on-call responsibilities for each hospital participatingin the plan;
- A description of the geographic area covered by the plan;
- the signature of an appropriate representative ofeach participating hospital;
- Assurances that local and/or regional EMS protocols include information on any such community on-call arrangements;
- A statement from each hospital participating in the plan affirming their respective obligations under EMTALA to perform medical screening and stabilizing treatment within its capacity, and to comply with EMTALA transfer and acceptance of transfer requirements; and
- An annual assessment by the participating hospitals of the efficacy of the plan.
Hospitals subject to EMTALA who struggle to maintain adequate ER coverage of key specialty areas including orthopedic surgery, cardiology and neurology should review these new rules and evaluate the potential to work with neighboring health care institutions to take advantage of this new opportunity as a way to better serve their communities and ease the often unweilding burden on specialty staffing caused by the EMTALA requirements.
