Public Citizen Study Finds 10% of Emergency Rooms Cited for Rejecting Patients, Despite Federal Law Prohibiting Care Denial
About 10% of U.S. hospitals were cited by the federal government from 1997 to 1999 for failing to comply with a law requiring them to provide emergency care to all patients regardless of whether they are insured or have the ability to pay, according to a report released yesterday by Public Citizen. Examining records from the Centers for Medicare and Medicaid Services (formerly HCFA), the advocacy group found 527 hospitals had "confirmed violations" of the 1986 Emergency Medical Treatment and Active Labor law, which is designed to prevent patient "dumping," the Dallas Morning News reports (Conklin, Dallas Morning News, 7/13). Moreover, just 85 of these incidents resulted in the hospital being fined for violating the law, according to Sidney Wolfe, one of the authors of the report and director of the Public Citizen Health Research Group (Riskind, Columbus Dispatch, 7/13). Under EMTALA, hospitals are required to examine all emergency room patients "without delay," meaning patients may not be asked about payment ability prior to examination. Hospitals must also attempt to stabilize patients, and if unsuccessful, must arrange transfer to more "sophisticated" facilities, which are also required to accept such patients (Rohrlich/Riccardi, Los Angeles Times, 7/13). Other findings from the report include the following:
Hospitals Respond
Hospital officials questioned the study, saying it exaggerated the prevalence of patient-dumping and was "misleading," the Morning News reports. They noted that many of the violations found in the report were "paperwork or clerical errors that didn't endanger patient care" (Dallas Morning News, 7/13). American Hospital Association spokesperson Rick Wade, noting that U.S. hospitals care for a million emergency room visits each year, said, "We have 5,000 hospitals in this country. The numbers (Public Citizen) is reporting are not significant and do not reveal any sort of trend. There has never been any evidence that patient dumping is rampant" (AP/USA Today, 7/12). And Maureen Mudron, another AHA spokesperson, said, "What this report is highlighting is the exception, not the rule" (Boston Globe, 7/13). The full Public Citizen report, titled "Questionable Hospitals," along with a state-by-state list of hospitals cited for patient dumping, can be found at http://www.citizen.org/questionablehospitals.
