Ensure hospital compliance with EMTALA
Recommendation
The Department of Health and Human Services (HHS) should issue guidance to hospitals on their obligations under the Emergency Medical Treatment & Labor Act (EMTALA) to stabilize and treat individuals with a substance use disorder (SUD), and Congress should provide financial resources to incentivize hospitals to hire appropriate staff for their emergency departments[1]
Background/summary
The Emergency Medical Treatment & Labor Act (EMTALA) ensures that hospitals provide emergency services, including stabilizing treatment for emergency medical conditions, regardless of an individual’s ability to pay.[2] Conditions related to substance use disorders (SUDs) are responsible for about one out of eleven emergency department visits, making hospitals an important location to initiate treatment.[3] Unfortunately, many emergency departments fail to comply with EMTALA by not conducting SUD screening and diagnosis assessments, by not providing medication for opioid use disorder (OUD), and by not providing post-discharge treatment options and medication.[4] Currently, many emergency departments do not provide adequate SUD screening and treatment due inadequate provider training and bias against SUDs.[5] Social workers and case managers can support hospitals by providing support services for individuals with SUD.[3] To improve SUD screening and treatment in hospitals, updated EMTALA guidance is needed to increase compliance. Congress should also pass legislation to incentivize the initiation of SUD care in emergency departments similar to the Improving Mental Health Access from the Emergency Department Act.[1]
citations
1. Presidential Commision. The President’s Commission On Combating Drug Addiction and the Opioid Crisis. Last Updated 2017.
2. U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services. Emergency Medical Treatment & Labor Act (EMTALA). Last Updated December 5, 2022.
3. Health Affairs. Addiction Is An Emergency: End Wait Times For Services And Expand Access To Life-Saving Medications. Last Updated December 13, 2021.
4. Legal Action Center. Emergency: Hospitals Can Violate Federal Law by Denying Necessary Care for Substance Use Disorders in Emergency Departments. Last Updated July 20, 2021.
5. Leslie W. Suen, MD, MAS, Anil N. Makam, MD, MAS, Hannah R. Snyder, MD, Daniel Repplinger, MD, Margot B. Kushel, MD, Marlene Martin, MD, and Oanh Kieu Nguyen, MD, MAS. National Prevalence of Alcohol and Other Substance Use Disorders Among Emergency Department Visits and Hospitalizations: NHAMCS 2014–2018. National Institutes of Health, National Library of Medicine, National Center for Biotechnology Information. Last Updated September 13, 2021.