PATIENT DUMPING: HHS Says It Will Crack Down on Doctors
Although the 1986 Emergency Medical Treatment and Active Labor Act (EMTALA) explicitly prohibits "patient dumping," physicians engaging in the practice have traditionally gotten off scot-free. But the HHS inspector general's office is working to change that, this week's Modern Healthcare reports. Since the law passed in 1986, the agency has settled only 15 cases against emergency room physicians who have denied patients treatment for financial reasons, although 13 of those cases have come in the past four years. "Hospitals are getting it," said Jessica Bowman, a lawyer with the inspector general, adding, "But physicians haven't so far. We want them to get it; that's why we're turning up the heat. I think you'll start to see more cases against physicians." Physicians and hospitals found to be in violation of EMTALA risk exclusion from Medicare and fines up to $50,000. HHS says that better resources, including abeefed-up staff, are enabling the agency to be more vigilant. The most common violators are "emergency room doctors seeking prior authorization from managed-care organizations before ... treating patients and on-call doctors ... who fail to show when called in for emergencies." Three physicians and two hospitals, Utah's Tooele Valley Regional and Oklahoma City's St. Anthony Hospital, have refused to settle charges and have taken their cases before federal judges. "In all three cases against the doctors, we think the behavior is gross and flagrant," said the inspector general's chief litigator Thomas Herrmann. But Robert McNamara, of Philadelphia's Temple University Hospital, worries that the crackdowns may be unfair, contending that "doctors are making reasonable medical decisions for legitimate medical reasons," for which the government is wrongly "ascribing financial motivations" (Taylor, 8/9 issue).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.