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DIAL is committed to providing education to improve patient outcomes and increase access to care. The provisions of Emergency Medical Treatment and Labor Act (EMTALA) apply to all individuals (not just Medicare beneficiaries) who attempt to gain access to a hospital for emergency care. In this edition, DIAL will provide education on the landscape of our state’s data for EMTALA investigations and compare it to national trends. The term “hospital” in this newsletter includes critical access hospitals (CAHs).
EMTALA is a federal law that imposes specific obligations on hospitals that offer emergency services. EMTALA requires hospitals with emergency departments to provide a medical screening examination (MSE) to any individual who comes to the emergency department and requests such an examination, and prohibits hospitals with emergency departments from refusing to examine or treat individuals with an emergency medical condition (EMC).
EMTALA complaint investigations triage
An EMTALA investigation is based on a complaint-driven allegation of noncompliance with two triage options determined by the regional office (RO) at Centers for Medicare and Medicaid Services (CMS).
- Allegations of EMTALA violations against hospitals may represent a probable immediate jeopardy (IJ), which requires the state to initiate the investigation within two business days after receipt of the authorization from the RO.
- The EMTALA complaint may also be prioritized as non-IJ high. In these situations, the investigation must be initiated within 45 business days of RO authorization.
Reference QSO-19-14-Hospitals, CAHs for the triage options released June 4, 2019 updates.
Iowa's standing for EMTALA investigations in federal fiscal year 2024
The number of EMTALA investigations for FFY 2024 in Iowa is significantly higher compared to other states. An estimated 744 ETMALA investigations were done across the nation in FFY 2024. Iowa investigated 35 EMTALA investigations, with 11 triaged as IJ, and 24 triaged as non-IJ high.
The chart below shows Iowa’s FFY 2024 EMTALA intakes triage investigations.
 Nationally, an estimated 87% of EMTALA complaints investigated in FFY 2024 resulted in no deficiency cited. The residual 13% of investigations resulted in EMTALA violations cited.
According to current finalized reports, Iowa had 10 investigations with EMTALA deficiencies; one EMTALA investigation resulted in an IJ cited, and four resulted in no EMTALA violations cited. See the chart below.
 When no deficiency is cited, the hospital is found in compliance with requirements and regulations.
Review the Outline of Data Tags Used for Citing Violations of Responsibilities of Medicare Participating Hospitals in Emergency Cases
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