Twenty-five years have now passed since the Emergency Medical Treatment and Active Labor Act (EMTALA)1 was enacted in 1986 to address the problem of “patient dumping” by hospitals because of an injured patient’s financial status or lack of health insurance. The statute was intended to close a gap in traditional state law by imposing on hospitals a legal duty, not recognized at common law, to provide emergency care to all persons presenting to a hospital’s emergency department, regardless of their ability to pay.2 To that end, the statute, under threat of civil monetary penalties, specifically prohibits delaying an appropriate medical screening examination or further medical examination and treatment in order to inquire about a person’s method of payment or insurance status.3 The focus is on whether there was disparate treatment of similarly situated plaintiffs.4

While the statute, in recent years, has received much less publicity than in the past, issues concerning the interpretation and application of EMTALA continue to arise, and are of particular concern to small community hospitals which typically must transfer patients for specialized treatment. This article will review the pertinent provisions of the statute, and discuss and offer suggestions for the defense of EMTALA claims that may arise in specific fact patterns.

Overview of the Statute

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