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.