HHS-OIG Settles Patient Dumping Statute Violations with Three Healthcare Providers
In the past two months, the Department of Health and Human Services Office of Inspector General has settled alleged violations of the federal patient dumping statute – The Emergency Medical Treatment and Labor Act (EMTALA) – with three healthcare providers. The settlements included penalties ranging from $60,000 to $100,000.
EMTALA was part of the Consolidated Omnibus Budget Reconciliation Act (COBRA) that was passed in 1986 and requires hospitals that receive payments from the HHS’ Centers for Medicare and Medicaid Services (CMS) to provide a medical screening examination (MSE) to all patients seeking treatment for a health condition regardless of the patient’s legal status or ability to pay. Stabilizing treatment must be provided unless the patient’s condition requires the patient to be transferred to another healthcare provider better equipped to administer stabilizing treatment. Organizations found to have violated EMTALA can face stiff financial penalties and, potentially, exclusion from federally funded healthcare programs.
Big South Fork Medical Center
In September, HHS-OIG entered into a $60,000 settlement agreement with Scott County Community Hospital, doing business as Big South Fork Medical Center (BSF) in Oneida, Tennessee. The HHS-OIG investigation determined there had been EMTALA violations on two separate occasions in 2021 when appropriate MSEs were not provided. In February 2021, a patient presented at the BSF Emergency Department (ED) with severe epigastric pain, nausea, and vomiting. The patient only received an abdominal x-ray, not a CT scan or blood tests such as a complete blood count (CBC) or basic metabolic panel (BMP) to check for an emergency medical condition, even though those tests were routinely available at the ED. The patient was discharged after 45 minutes and was treated at a different hospital for appendicitis.
In June 2021, another patient presented at the ED via an emergency medical service. The patient had a history of anemia and weakness but a CBC was not provided to assess the patient’s anemia and the patient was discharged with a diagnosis of acute generalized weakness secondary to chronic anemia and a differential diagnosis of metabolic disorder; however, no lab tests were conducted to determine the cause of the symptoms. Around 9 hours after being discharged, the patient visited a different hospital and received treatment for severe anemia.
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Coliseum Medical Center
In October, Coliseum Medical Center in Macon, Georgia agreed to a $100,000 settlement to resolve an alleged EMTALA violation. HHS-OIG determined that in November 2018, a woman presented to the ED with a female child of 5 or 6 years requesting the child be examined to determine if she had been sexually assaulted. The medical center said they did not have any rape kits and refused to perform a pelvic examination of the child and said local authorities and the local crisis center would be contacted for consultation. The woman and child left Coliseum Medical Center without receiving an MSE.
Dr. Van Stephen Monroe, Jr.
In October, Dr, Van Stephen Monroe, Jr. in Chattanooga, Tennessee agreed to a $65,000 settlement to resolve an alleged EMTALA violation. The HHS-OIG investigation determined that Dr. Monroe failed to accept the transfer of a patient with an emergency medical condition, a myocardial infarction. The patient had visited a healthcare provider who did not have the specialized capabilities or capacity to treat the patient at the time. Dr. Monroe and his participating hospital did have the capabilities and capacity to treat the patient but the appropriate transfer was refused.
