Understanding EMTALA and the Courts

EMTALA is a part of the Medicare title of the Social Security Act, and Medicare is administered by the Centers for Medicare & Medicaid Services (CMS) in the Department of Health and Human Services (HHS). 42 U.S.C. ' 1395dd; see generally 42 U.S.C. '1395 et seq. EMTALA is enforced in two ways — by CMS and by private causes of action. CMS may impose a hefty civil monetary penalty on a hospital or physician that violates the act's requirements. 42 U.S.C. ' 1395dd(d)(1). In particularly egregious cases, the agency may terminate a physician or hospital's right to participate in the Medicare and Medicaid programs. 42 U.S.C. '' 1395dd(d)(1)(B), 1395cc(b)(2)(A). As discussed in last month's newsletter, CMS has issued comprehensive regulations interpreting EMTALA's requirements. See 42 C.F.R. ' 189.24, 68 Fed. Reg. 53222 (Sept. 9, 2003).

Private causes of action can be brought against hospitals by two kinds of parties: by any “individual who suffers personal harm as a direct result” of the hospital's violation of EMTALA; or by any “medical facility that suffers a financial loss as a direct result” of a hospital's violation of EMTALA. 42 U.S.C. ' 1395dd(d)(2)(A), (B). In either case, the plaintiff may “obtain those damages available for” personal injury or financial loss (as the case may be) “under the law of the State in which the hospital is located, and such equitable relief as is appropriate.” Id. The statute of limitations is 2 years. 42 U.S.C. ' 1395dd(d)(2)(C).