NAEMSP, Holland & Knight: Latest Guidance on EMTALA, COVID-19

Below is a summary of EMTALA guidance from NAEMSP's partners at Holland & Knight:

EMTALA Requirements Continue to Apply: Hospitals remain obligated under EMTALA to provide a medical screening exam to every individual who comes to the ED for examination or treatment of a medical condition to determine if they have an emergency medical condition. Hospitals must provide necessary stabilizing treatment for individuals with an emergency condition within the hospital's capability and capacity, and hospitals must provide for transfers of individuals, as appropriate.

Signage, Directing Patients, and Other Barriers to the ED: EDs cannot use signage or other barriers to prevent individuals suspected of having COVID-19 from coming to the ED. However, hospitals may use signage to direct individuals to certain locations within a hospital: e.g., if the hospital has set a dedicated location to triage potential COVID-19 patients.

Transfers of COVID-19 Patients to/from Hospitals: Hospitals with capacity and specialized capabilities needed to provide stabilizing treatment for COVID-19 are required to accept appropriate transfers from hospitals without such necessary capabilities. CMS reminds providers that this obligation applies to all Medicare-participating hospitals regardless of whether the recipient hospital has a dedicated ED. CMS encourages hospitals to coordinate with state/local public health officials.

COVID-19 Screening Locations (On-site): When patients come to the ED, a hospital may set up alternative medical screening examination screening locations for COVID-19 outside of the ED. After a patient is logged-in at the ED, a patient can be re-directed to these separate locations. CMS also notes that this initial patient logging and re-direction can also take place outside of the ED.

COVID-19 Screening Locations (Off-site): Hospitals may also set up off-campus locations for influenza-like illness screening for COVID-19. CMS further notes that hospitals may encourage the public to go to these off-site locations rather than coming to the hospital to obtain screening for COVID-19. Such off-site locations cannot be held out as a location that provides emergency care (unless it is already a dedicated off-campus ED of the hospital). 

Click here for a memo regarding the legislative and administrative state of play as it pertains to the COVID-19 response.