EMTALA Reviews
As Medicare's contracted Quality Improvement Organization (QIO) in Idaho and Washington, Qualis Health reviews local cases that may be in violation of the Emergency Medical Treatment and Active Labor Act (EMTALA).
When Medicare refers a case to us, our responsibilities include:
- Determining whether
- The medical screening was adequate
- An emergency medical condition existed and, if so, was stabilized
- The care involved any quality concerns
- Submitting initial findings to Medicare
- When requested, submitting a comprehensive final report to Medicare
- Providing an opportunity for the hospital and involved physicians to discuss the issues
We do not state an opinion regarding whether a violation occurred.
What is EMTALA?
The federal Emergency Medical Treatment and Active Labor Act (EMTALA), passed in 1986, is designed to prevent hospitals from "dumping" patients who request emergency care but are unable to pay for it.
The law applies to all hospitals that participate in the Medicare program. In general, hospitals must provide appropriate screening and stabilizing care to patients before discharging or transferring them. For details about the regulation, please see Medicare's website.
Reporting a Potential EMTALA Violation
If you believe a potential EMTALA violation has occurred, please contact:
The Centers for Medicare & Medicaid Services
Region X
2201 Sixth Avenue MS/RX40
Seattle, WA 98121-2500
206-615-2354