Chances are remote that a hospital or physician will be fined for an EMTALA violation. One hundred sixty-four hospitals agreed to pay civil monetary penalties to resolve an EMTALA violation from 1997 through April of 2001, according to Public Citizen, a consumer watchdog group. Thirteen physicians over that same time period agreed to pay civil monetary penalties to resolve dumping violations.
A Look at the Numbers
The average penalty paid by hospitals from 1998 to 2000 was $29,631, an increase from the average penalty of $17,904 in 1996. Penalties for the 13 physicians ranged from $5,000 to $45,000 and averaged $19,967.
Five hundred twenty-seven hospitals (about 9 percent of all U.S. hospitals) had EMTALA violations basically from 1997 to 1999. Not every violation is penalized with a fine. The Office of Inspector General (OIG) considers the nature of the offense, history of prior offenses and other factors in deciding whether to assess a penalty. Since EMTALA was enacted in 1986, 261 of the 975 (26.7 percent) EMTALA violations by hospitals and physicians have resulted in monetary penalties.
Some EMTALA violations are of a minor nature such as simple documentation omissions. But all 13 physicians who have been fined violated a screening, transfer or stabilizing treatment provision, the most serious offenses. Ninety-one percent of hospitals cited for an EMTALA infraction violated one or more of the three most serious provisions.
Six hospitals with a highly serious EMTALA violation( s) have been prohibited from participation in Medicare. A termination can be reversed if a hospital implements plans of corrections and shows compliance with EMTALA.
The statistics don’t tell the whole story about EMTALA, of course. For one thing, no one knows how many violations go unreported. A patient transfer that may constitute an EMTALA violation must be reported by the receiving hospital to the Centers for Medicare and Medicaid Services, but that has happened just once since 1995.
Public Citizen officials have charged that the statistics show that hospitals are flouting the law. But emergency departments handle more than 100 million visits annually, and emergency room physicians and hospital officials say they take EMTALA seriously and try to comply with its complex provisions.