CMS ISSUES MEMORANDUM REGARDING HOSPITAL EMTALA OPTIONS IN EVENT OF H1N1 FLU PANDEMIC.

On August 14, 2009, CMS issued a memorandum on requirements of hospitals under the Emergency Medical Treatment and Labor Act (“EMTALA”) in the event of a surge in hospital emergency room visits for H1N1 influenza treatment. EMTALA requires all hospitals to provide an appropriate medical screening examination on presentation to determine whether the patient has an Emergency Medical Condition. If it determines that one exists, the hospital must treat and stabilize the patient within its capacity or transfer a patient to a hospital that has a capability and capacity to stabilize the condition. In anticipation of a surge in emergency room visits CMS issued additional guidance for hospitals to comply with EMTALA.

The Memorandum suggests the development of alternative screening sites on the medical campus of the hospital and the tailoring of the medical evaluation to the needs of the circumstances, either simple or complex as the presenting case may be. The hospitals must provide qualified personnel and provide stabilizing treatment or appropriate transfer, including moving them from the alternative site to other on campus departments.

Hospitals may encourage patients to go to off campus, hospital controlled sites but cannot direct patients arriving on campus to go to off campus sites. Unless the off campus site is already designated as and Emergency Department of the Hospital, EMTALA regulations due not apply there. The off campus site should be staffed with people trained to evaluate people with Influence Like Illness. (“ILI”). Hospitals are encouraged to coordinate referral and transportation efforts for people with continuing emergency treatment needs to appropriate facilities. The Memorandum advises that CMS may issue waivers that will permit hospitals to redirect patients to off campus sites in accordance with a State emergency or pandemic preparedness plan and to effect transfers ordinarily prohibited by EMTALA so long as the transfer is necessitated by the circumstances of the declared emergency.