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    Many ERs Illegally Refuse to Treat Patients, Consumer Group Says


    The hospital industry objected to the findings in the report. "This report highlights the exception, not the rule," Alicia Mitchell, spokeswoman for the American Hospital Association, tells WebMD.

    Most hospitals do not violate EMTALA, she says, noting that U.S. hospitals see 100 million emergency visits a year, which results in $20 billion in uncompensated care.

    Mitchell concedes that some instances of patient dumping do occur. But she insists that these are the result of "poor judgement" or a failure to document care that was actually delivered.

    The AHA works with hospitals to make sure they understand their responsibilities by providing educational programs and issuing advisories whenever there is a change that affects EMTALA regulations, Mitchell says.

    Public Citizen believes that one solution to the problem may be federal legislation that creates liability for insurers that require prior authorization or that refuse to reimburse for emergency treatment.

    Senators Bob Graham (D-Fla.) and Lincoln Chafee (R-R.I.) have introduced the Access to Emergency Medical Services Act, which would require insurance companies to pay for emergency treatment without the need for prior authorization, Wolfe tells WebMD. He notes that Public Citizen is sending the report to members of Congress and president Bush.

    Another way to increase hospital compliance with EMTALA may be to increase the maximum allowable fine to hundreds of thousands of dollars, Wolfe said.

    In the meantime, Wolfe has the following recommendations to consumers to avoid being dumped:

    • Patients should, if possible, have a friend or family member attend the ER with them.
    • If a patient suspects he or she is being dumped, he or she should immediately complain to the hospital administrator and inform them that they plan to report the incident to the Centers for Medicare and Medicaid Services, or CMS.

    The CMS and the Office of Inspector General, the two governmental agencies directly responsible for enforcing EMTALA, declined to comment about this story to WebMD.

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