CMS to Propose Rule Change for Non-Emergency Facilities Accepting Medicare Beneficiaries

CMS today is expected to publish in the Federal Register a proposed rule that would eliminate a requirement that hospitals accepting Medicare funds provide emergency care to patients even at non-emergency facilities, the Wall Street Journal reports. Under a proposed revision to the 1986 Emergency Medical Treatment and Labor Act, or EMTALA, "off-campus" facilities, such as radiology and mammography clinics, associated with hospitals that accept Medicare beneficiaries would no longer have to "screen and stabilize" patients who seek emergency care at those facilities. Instead, the proposed rule would require non-emergency facilities to devise procedures, such as calling 911, to respond to patients seeking emergency treatment. Only hospital facilities that provide emergency services, such as urgent-care centers, still would be required to respond to emergency patients on-site. Hospital industry lobbyists had pushed for the revision, saying the current requirement is an "illogical expansion" of EMTALA, which was enacted to prevent hospitals that receive Medicare funding from refusing to treat patients who cannot pay. CMS Administrator Tom Scully said that the previous rule "caused a lot of havoc for hospitals" with non-emergency facilities because such hospitals "spent a huge amount of money" to train all personnel to handle emergency situations.

The proposed rule change also would allow hospital-owned ambulances to transport patients to any facility allowed under its protocol. Under the current rule, a hospital-owned ambulance is subject to EMTALA, which requires it to transport patients to the hospital that owns it. Also included in the rule is a proposed 2.75% increase in fiscal year 2003 for hospitals providing inpatient services to Medicare beneficiaries. The payment increase is part of an annual update. The proposed rule will be posted for public comment until July (Lueck, Wall Street Journal, 5/9).