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The Emergency Medical Treatment and Active Labor Act (EMTALA) is an act of the United States Congress, passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA). It requires hospital Emergency Departments that accept payments from Medicare to provide an appropriate ''medical screening examination'' (MSE) to individuals seeking treatment for a medical condition'','' regardless of citizenship, legal status, or ability to pay. There are no reimbursement provisions. Participating hospitals may not transfer or discharge patients needing emergency treatment except with the informed consent or stabilization of the patient or when their condition requires transfer to a hospital better equipped to administer the treatment.〔 EMTALA applies to "participating hospitals." The statute defines "participating hospitals" as those that accept payment from the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) under the Medicare program.〔 (e)(2) The term "participating hospital" means a hospital that has entered into a provider agreement under section of this title.〕 "Because there are very few hospitals that do not accept Medicare, the law applies to nearly all hospitals."〔(Emergency Medical Treatment and Active Labor Act ) summary, Families USA.〕 The combined payments of Medicare and Medicaid, $602 billion in 2004,〔(Key Medicare and Medicaid Statistics ) from kff.org〕 or roughly 44% of all medical expenditures in the U.S., make not participating in EMTALA impractical for nearly all hospitals. EMTALA's provisions apply to all patients, not just to Medicare patients.〔(Text of act ) from law.cornell.edu〕〔(EMTALA FAQ ) Website / Information from Garan Lucow Miller, P.C〕 The cost of emergency care required by EMTALA is not directly covered by the federal government. Because of this, the law has been criticized by some as an unfunded mandate.〔(Fact Sheet: EMTALA ) from the American College of Emergency Physicians accessed 2007-11-01〕 Uncompensated care represents 6% of total hospital costs.〔(American Hospital Association, Trends Affecting Hospitals and Health Systems 2011, Chapter 4, Slide 7 )〕 ==Mandated and non-mandated care== Congress passed EMTALA to eliminate the practice of "patient dumping," i.e., refusal to treat people because of inability to pay or insufficient insurance, or transferring or discharging emergency patients on the basis of high anticipated diagnosis and treatment costs. The law applies when an individual seeks treatment for a medical condition "or a request is made on the individual's behalf for examination or treatment for that medical condition."〔 The U.S. government defines an emergency department as "a specially equipped and staffed area of the hospital used a significant portion of the time for initial evaluation and treatment of outpatients for ''emergency medical conditions'' ."〔(American College of Emergency Physicians: EMTALA Fact Sheet ), accessed 2007-10-05.〕 This means, for example, that outpatient clinics not equipped to handle medical emergencies are not obligated under EMTALA and can simply refer patients to a nearby emergency department for care.〔 An ''emergency medical condition'' (EMC) is defined as "a condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in placing the individual's health (the health of an unborn child ) in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of bodily organs." For example, a pregnant woman with an emergency condition must be treated until delivery is complete unless a transfer under the statute is appropriate.〔 Patients treated under EMTALA may not be able to pay or have insurance or other programs pay for the associated costs but are legally responsible for any costs incurred as a result of their care under civil law. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Emergency Medical Treatment and Active Labor Act」の詳細全文を読む スポンサード リンク
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