The Department of Health and Human Services Office of Inspector General (HHS-OIG) has announced that two settlements have been agreed to resolve alleged violations of the Emergency Medical Treatment and Labor Act (EMTALA). EMTALA was enacted by Congress in 1986 to ensure public access to emergency medical services. EMTALA requires Medicare-participating hospitals that offer emergency services to provide a medical screening examination (MSE) to patients who present to their emergency department requesting an examination or treatment for an emergency medical condition, regardless of the patient’s ability to pay.
A patient must be provided with stabilizing treatment if the MSE determines that they have an emergency medical condition. If the hospital lacks the capability to provide stabilizing treatment, or if requested by the patient, they must initiate an appropriate transfer. The receiving hospital must have the available space and qualified personnel and must agree to accept the transfer.
The transferring hospital must send all medical records related to the emergency condition that are available at the time of the transfer, and send all other records as soon as is practicable. Hospitals that violate EMTALA can face heavy civil monetary penalties, and individuals harmed may pursue legal action for EMTALA violations. Merit Health Central Hospital Merit Health Central Hospital in Jackson, Mississippi, formerly known as Central Mississippi Medical Center, has agreed to settle alleged EMTALA violations with HHS-OIG and will pay a $350,000 financial penalty.
Unusually, the case relates to patients who presented at the hospital emergency room more than a decade ago. The delay in issuing the penalty was due to a False Claims Act lawsuit related to the alleged EMTALA violations that was working its way through the legal system. HHS-OIG’s investigation determined that the hospital failed to provide an adequate MSE and stabilizing treatment to fourteen patients who presented to its emergency room between January 2013 and April 2015 requesting an examination or treatment for a medical condition.
Out of the fourteen individuals, nine had emergency medical conditions and were transferred to another hospital between January 2013 and May 2013 without providing an appropriate MSE and treatment to stabilize the patients to minimize the risk of transfer, despite having staff within its facilities or available as on-call physicians who could have provided the necessary stabilizing treatment.
In six cases, the transfers were based on its application of Central MS Trauma Region Trauma Activation Criteria and Destination Guidelines for the transfer of individuals with penetrating trauma to another hospital. Several of the patients had presented with gunshot wounds. Four patients presented to the emergency room between March 2015 and April 2015 with a psychiatric emergency medical condition and were not provided with an appropriate MSE within the capabilities of the hospital or stabilizing treatment.
The four individuals were transferred by taxi in an unstable condition to a homeless day shelter. One patient presented to the emergency room in March 2015 for treatment related to end-stage renal disease and had an emergency medical condition requiring dialysis, yet stabilizing treatment was not provided even though it was within the hospital’s capabilities.
NorthShore University Health System NorthShore University Health System in Evanston, Illinois, agreed to settle alleged an EMTALA violation concerning a patient who presented to its emergency room in February 2025 complaining of leg pain and nausea. The 64-year-old man presented to the emergency department at 10:53 a. m.
and was triaged at 11:15 a. m. During triage, the patient’s vitals were taken.
He had a heart rate of 126 bpm and was assigned an emergency severity index (ESI) level of 2 – high risk. The patient was placed in a wheelchair in a waiting room but was not reassessed, and his vitals were not rechecked. The patient was found slumped over and unresponsive in the wheelchair at 8:55 p.
m – more than 9 hours after he was triaged. The patient was determined to be in cardiac arrest, and CPR was quickly initiated. HHS-OIG’s investigation determined that Northshore failed to provide an appropriate MSE.
The case was settled with a $105,000 financial penalty. The post Merit Health Central Hospital & NorthShore University Health System Settle EMTALA Violations appeared first on The HIPAA Journal .
Originally published at hipaajournal.com
