EMTALA stands for the Emergency Medical Treatment and Labor Act, which is a federal law enacted by Congress in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985. The law 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) . The term “hospital” includes critical access hospitals, and the provisions of EMTALA apply to all individuals (not just Medicare beneficiaries) who attempt to gain access to a hospital for emergency care.

EMTALA regulations can be broken down into three important provisions that are important to hospitals and EMS systems:

• Patients who present to a hospital emergency department (ED) (which includes a hospital-based EMS system) must undergo an "appropriate" medical screening examination by a physician or qualified medical person to determine whether they have an "emergency medical condition."

• If an emergency medical condition exists, the hospital must provide stabilizing treatment within its capability and capacity, regardless of the patients ability to pay.

• If the hospital is unable to provide the necessary stabilizing treatment, it must arrange for an appropriate transfer to another facility that can provide the necessary treatment.

EMTALA regulations are often open to interpretation because of the language used in the initial legislation, which can often lead to significant confusion for healthcare providers and hospital administrators. Failure to follow EMTALA regulations can result in substantial financial and legal consequences for hospitals and EMS systems.