Length of Program: 120 minutes.


Course Description:

This 2-part program will include the 5 new updates on EMTALA occurring in the year 2001. A recent survey indicated a significant knowledge deficit on EMTALA among Nurses and Physicians. In fact, only 27% know about the 1999 CMS/OIG advisory bulletin and only 65% knew of the CMS 1998 interruptive guidelines. Because of this there is an increased awareness of EMTALA by CMS and an increased number of complaints being filed against hospitals based on EMTALA. This program will also cover the legal requirements of EMTALA, case law update, and how to respond to an EMTALA complaint survey.


Content for the program will include the following:

Introduction to EMTALA

  • History

  • NEW OIG reports on the enforcement process and the survey of hospital ED’s.

  • NEW CMS guidelines for determining immediate jeporady on EMTALA.

  • Purpose

  • Statute/amendments

  • Interim final rules

  • Interpretive guidelines

  • CMS/OIG Bulletin (managed care patients, best practices, etc.)

  • New PPS rules (extension of EMTALA to off-campus outpatient facilities and departments)

  • Purpose of EMTALA

  • NEW GAO report on EMTALA Implementation and Enforcement Issues (June 22, 2001)

  • NEW CMS release of Q&A on EMTALA, July 20, 2001.


Hospital Obligations

  • Who does EMTALA apply?

  • Medical screening exam

  • Necessary stabilization treatment

  • Transfers

  • Qualified medical personnel

EMTALA Requirements

  • Notice and record keeping

  • Signs

  • Whistleblower protection

  • Documentation

  • Control logs

OIG/CMS Advisory Bulletin

  • Update on 250 yard rule

  • Patients who leave AMA

  • Sanctions

  • Managed care

  • Dual staffing

  • QMP performing MSE

  • Authorization for payment

Application of EMTALA to Hospital-Based Providers

  • Prospective Payment System (PPS) rules

  • Expansion of EMTALA to on-campus

  • Expansion of EMTALA to off-campus

  • Capabilities of hospital

  • Protocols

  • Transfers from off-campus sites

Target Audience:

CEOs, COOs, emergency department managers, OB managers, emergency department physicians, emergency department nurses, compliance officers, legal counsel, risk managers, and nurse managers. Also any other clinics or facilities that are classified as a provider based organization.


At the conclusion of this program, participants will be able to:

  • Document what EMTALA requires of a patient who wants to sign out against medical advice?

  • Define what is meant, “come to the emergence department” for a patient requesting medical care.

  • Describe what would be an adequate medical screening exam.



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