Be careful of EMTALA and HIPAA violations
If you are employed by or on the staff of a hospital, you must be very careful when dealing with or discussing patients. Two federal statutes that can truly make your life miserable are the Emergency Medical and Labor Act (EMTALA) and Health Insurance Portability and Accountability Act (HIPAA).
EMTALA, for the most part, applies to patients who come to the emergency room. These patients must be evaluated and treated regardless of their insurance status or any other factor that would affect getting medical care. It is very easy to comply with this act. You, the physician, simply evaluate every person who comes into the ER and, because you are salary, you do not care one way or the other as to whether the person has or does not have insurance. You are getting paid regardless. But things are never as simple as they seem. What happens when the “patient” is not really a “patient”?
For instance, a person walks into the hospital ER and says that she is pregnant and wants a sonogram. The ER doctor is called by the nurse and tells the patient that the sonogram equipment has malfunctioned. An ambulance is called and the patient is correctly taken to a hospital close by which does have a functioning sono. Nothing adverse occurs to the patient and all is well. It is important to note that trouble may be just around the corner. Did you, the ER physician, ensure that a record was opened up for this “patient”? Did you do a complete physical and document her status in that record? If not, it is possible that the EMTALA “police” will come down on you with a sledgehammer. It could be determined that you have violated a federal statute. An investigation will commence. You may be questioned about your conduct. You and your hospital may be cited with a violation. At this point, the hospital administration will go into survival mode and may throw you under the bus. If you are terminated, it will be reported to the Office of Professional Medical Conduct (OPMC) and you may be interviewed. Your termination will also be posted on the National Practitioner’s Data Base, which will burden you for the remainder of your career. Believe me, I have seen situations like this happen regularly. Once you know that you will be terminated by the hospital, have the hospital’s general counsel declare that the investigation is over and that it is no longer “pending”. You can then resign without the hospital generating a report that can ruin your career. In order to protect yourself, consult with an experienced OPMC attorney.
The long and short of it all is that, unfortunately, the hospital administration will always protect the hospital before the careers of the staff. Be very careful what you say, do, or email. Again, you must realize that the hospital administration may sacrifice your career to protect the institution.
This is an unfortunate reality that is not isolated to EMTALA violations. This applies to HIPAA as well. You can find my HIPAA article here. If you are facing a similar situation, you need an attorney to represent your interests and protect your future. Contact Walker Medical Law.
This article was written and published by Paul E. Walker, an experienced New York City OPMC & OPD Lawyer. Please contact the Walker Medical Law firm to set up a free initial consultation.