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ER aid guaranteed -- even if you can't pay

Here are other significant rules governing emergency care:

  • New rules specify that anything in the patient's behavior or appearance that causes even a lay person to believe the patient needs immediate attention may start protections. Translation: If you show up to an ER in obvious distress, almost any responsible person can start the emergency medical procedures. You don't have to wait for a doctor to show up to declare that it's an emergency.
  • To be certain you're protected by these laws you must go to the ER -- not just show up on hospital grounds or ask for treatment in the lobby. If you go to a dedicated emergency room -- even if it is not on the hospital's main campus -- the EMTALA rules apply. If it's an emergency, they have to see you and treat you.
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  • If you go to a hospital's off-campus facility where there is no ER, the hospital can't reject you unless you are an outpatient, already receiving services.
  • A hospital with no ER must have written procedures to appraise and refer emergency patients elsewhere.
  • A hospital that transports a patient to its facility by its own ambulance is obliged under EMTALA to receive the patient, even if the crew was directed to another hospital. However, hospital-owned ambulances operating under community-wide rules do not always make that hospital responsible for screening, treating or stabilizing a patient. It could be the responsibility of the hospital to which the ambulance is directed to take the patient.

Pay back for some

Hospitals that fall under the auspices of the Hill-Burton Act are governed by a different set of rules. Since the law took effect in 1946, hospitals that receive federal dollars to build or upgrade their health facilities are forever required to provide community service to their local area. At those facilities, if you have a genuine emergency and can't afford to pay, you may be eligible for free medical treatment. And in certain states patients may be able to get some charity care, too.

Also, for 20 years after the hospital has received those federal dollars, they must also provide a "reasonable volume" of free services to people who cannot pay for them -- as much as 10 percent of all the grants the hospital received, or 3 percent of the hospital's annual operating costs.

These hospitals must not only keep the emergency room door open to everyone in their service area -- including those unable to pay -- but they also have a duty to tell patients of government programs for which they could be eligible.

The laws vary slightly by state, but you can locate a Hill-Burton facility in your own area by visiting the Health Resources Services Administration (HRSA), calling 1-800-638-0742, or through the program locator at the Health Assistance Partnership.

PAGE 1 | 2  
-- Posted: July 7, 2004
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