The Emergency Medical Treatment and Active Labor Act (EMTALA) is part of the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1996. The Act requires hospitals and ambulance services to provide care to anyone needing emergency medical treatment regardless of citizenship, legal status, or ability to pay. There are no reimbursement provisions. Persons needing emergency treatment can be discharged only under either their own informed consent or when their condition requires transfer to a hospital better equipped to render treatment.

EMTALA applies to all Medicare participating hospitals. The only hospitals exempt from EMTALA are the Shriners Hospitals for Children, Indian Health Service hospitals, and Veterans Affairs hospitals.

The Act was passed to address “patient dumping,” i.e., the practice of refusing to treat persons because of their inability to either pay, lack of sufficient health insurance, and/or transferring or discharging emergency patients on the basis of anticipated diagnosis or high treatment costs. EMTALA applies to all individuals with medical emergencies that arrive at an emergency department whether or not their condition is visible to others or is simply stated by the individual with no external evidence.

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