EMTALA Guidance for COVID-19

March 12, 2020

The Centers for Medicare & Medicaid Services (CMS) has released a new document related to COVID-19 and Emergency Medical Treatment and Labor Act (EMTALA) requirements. CMS has sent a memo to State Survey Agency (SSA) directors that provides information concerning implications of COVID-19 for their compliance with EMTALA. It includes a question and answer document specific to EMTALA obligations and COVID-19, which emphasizes the importance of reliance on Centers for Disease Control and Prevention (CDC) guidance regarding isolation and infection control measures. The document also includes a fact sheet for addressing increased surges in the numbers of patients presenting to the emergency department (ED).

The guidance reinforces hospitals existing obligation for screening, stabilization and transfer, stating that hospitals and critical access hospitals are expected to consider guidance from CDC and public health officials in determining whether they have the capability to provide appropriate isolation required for stabilizing treatment and/or to accept appropriate transfers.

It does establish some latitude for hospitals and health systems for setting up screening sites away from the ED. Specifically, CMS states that alternative screening sites may be located in other buildings on a hospital’s campus or in tents in the parking lot, as long as they are determined to be an appropriate setting for medical screening activities and meet the clinical requirements of the individuals referred to these settings.  Hospitals may also set up screening sites at off-campus, hospital controlled sites, and encourage the public to go to those sites instead of the hospital for screening. However, an individual who presents to the ED or hospital campus may not be directed to go to one of these sites.

Other information covered in an IHA memo discusses:

  • Medicare Advantage (MA) and Part D requirements and flexibilities;
  • Cost-sharing for high-deductible health plans;
  • Respirator and face mask use for healthcare workers; and
  • Health and safety for home health agency (HHA) and dialysis providers.