Look closely at EMTALA in light of Scruggs suits
Allegations of Emergency Medical Treatment and Labor Act (EMTALA) violations as part of the charity care lawsuits should prompt risk managers to take yet another hard look at how their emergency department staff discuss payment with patients, says Bryan Liang, MD, PhD, JD, a professor of law, medicine, and public policy, and executive director of the Institute for Health Law Studies at California Western School of Law in San Diego.
Watch for systems and procedures that skate a little too close to the edge of what's allowed and what's not. For example, look for practices in which the staff wait until the examination is under way or just finished, and then they go to the patient with paperwork and start discussing finances. That discussion does not happen before stabilization, so technically it probably wouldn't be a violation, Liang says. But it's so close that it can look like coercion.
"Any appearance of impropriety can invite a closer look and fines," he says. "With the lawsuits creating this atmosphere of closer scrutiny, you don't want to play it that close to the edge."
To be safe, Liang recommends waiting until the patient is discharged before asking about a payment plan or other options. Your collections department may not be crazy about that strategy because some patients may be eager to get out the door instead of talking finances, but Liang says it is the risk manager's job to contradict those optimal collections practices when they put the organization at risk.
"Risk managers have a responsibility to say that optimizing revenue can't always be the main concern, no matter how important that can be to the organization," he says. "That attitude can lead to serious risks down the road."
Allegations of Emergency Medical Treatment and Labor Act (EMTALA) violations as part of the charity care lawsuits should prompt risk managers to take yet another hard look at how their emergency department staff discuss payment with patients.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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