Can hospitals refuse to treat poor and uninsured patients?

Access to emergency care is a human right, as maintained by the World Health Organization. However, unequal access to such a right remains a persistent plight in the U.S. This crisis is known as patient dumping, which is the failure of hospitals to conduct proper screening, treatment, stabilization or transfer of poor and uninsured patients.

In a study of 160 US hospitals, researchers found that uninsured patients with common medical conditions, like pneumonia and asthma, have higher odds of discharge or transfer than privately insured patients. This issue stands at the intersection of legal, medical and social systems and determining how to go about it when you end up as a patient is all too important.

EMTALA enforcement

The Emergency Medical Treatment And Labor Act (EMTALA) makes patient dumping illegal. EMTALA is a federal law requiring Medicare-participating hospitals to provide emergency medical services despite a patient’s financial or insurance status.

The process begins with the Centers for Medicare & Medicaid Services receiving a complaint for a potential EMTALA violation. After an investigation, hospitals can deal with the incident through corrective measures. In cases of negligence, civil monetary penalties apply under the Department of Health and Human Services Office of Inspector General (OIG).

There are instances, such as in a Florida facility, where there is a settlement agreement between the hospital and the OIG. In the event of gross violations, banning hospitals and doctors from Medicare and other federal health programs take place. Further, if your condition worsens or other facts of your case show medical malpractice, you may also sue for damages.

On the other hand, there are contentions that hospital compliance is tough, especially for small-scale hospitals. EMTALA is an added burden to their overworked and underpaid staff trying to deliver their services even with limited resources.

What this means for you

Facing inequity at a time when you are sick is cruel. On top of trying to recover physically, you also need to gather details to file a lawsuit. A legal resource can help you seek the suitable care you should have received in the first place.