CMS has adopted changes to the regulations governing the Emergency Medical Treatment and Labor Act of 1986 (EMTALA) to include rules for community call plans and amend the regulations governing the on-call list. The regulations, effective October 1, 2008, were included in the fiscal year 2009 inpatient prospective payment system (IPPS) final rule.
In the 2009 IPPS proposed rule, CMS expressed its intent to revise EMTALA regulations to “clarify” that, when an unstable patient was admitted at one hospital and, subsequently, was transferred in an unstable condition via an appropriate transfer to a facility with specialized capabilities, the “receiving hospital” had an EMTALA obligation to accept the individual so long as the transfer was appropriate and the receiving hospital had the capacity to treat the individual.
CMS finalized the regulations that would permit hospitals to meet the EMTALA requirement for maintaining an on-call physician list by participating in a formalized community call plan among hospitals, and retained all but one of the proposed call plan elements described in the proposed rule. The requirement that hospitals demonstrate evidence that they have analyzed the specialty on-call needs of the community to be served by the call plan was removed because the proposed requirement would be duplicative of the existing requirement that a hospital must assess the call plan annually.
Language stating that a hospital was required to maintain an on-call list “in a manner that best meets the needs of the hospital’s patients” was removed. The regulations have been amended to state that an on-call list must be maintained “in accordance with the resources available to the hospital” and include sufficient guidance that a hospital is obligated to provide on-call services based on the resources it has available at the time, including the availability of specialists.
Final rule, 73 FR 48434, 48654, Aug. 19, 2008, Health Care Compliance Reporter, ¶700,075
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