A Message From Our Partners at Holland & Knight
Update - COVID-19

Thank you for all of the incredible work you are doing in the field.  I wanted to share the latest guidance from CMS regarding EMTALA and a summary below.  Note we have not seen guidance on EMTALA Section 1135 waivers. We will update you should further guidance be released. Click here for a memo regarding the legislative and administrative state of play as it pertains to the COVID-19 response.

I also encourage you to reach out to your congressional offices to inform them of the challenges you are experiencing in their districts on the ground, i.e., lack of PPE equipment, personnel shortages, etc.  For example, Dr. Ritu Sahni, NAEMSP Past President, had a great call with Rep. Kurt Schrader's (D-OR) office today.

Most staff are teleworking, so you will need to e-mail them to set up a call.  Please keep in mind that congressional staff are a bit inundated, so you may not receive an immediate response.  Click here to download a contact list for all healthcare staff listed by Member of Congress (the Member's last name is in bold print). If you need any help with outreach, please let us know.  We are happy to help make the connection.
 
Miranda Franco | Holland & Knight
Senior Policy Advisor
Holland & Knight LLP
800 17th Street N.W., Suite 1100 | Washington, District of Columbia 20006
Phone 202.469.5259 | Fax 202.955.5564
miranda.franco@hklaw.com | www.hklaw.com

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EMTALA Requirements Continue to ApplyHospitals remain obligated under EMTALA to provide a medical screening exam to every individual who comes to the ED for examination or treatment of a medical condition to determine if they have an emergency medical condition. Hospitals must provide necessary stabilizing treatment for individuals with an emergency condition within the hospital's capability and capacity, and hospitals must provide for transfers of individuals, as appropriate.

Signage, Directing Patients, and Other Barriers to the ED: EDs cannot use signage or other barriers to prevent individuals suspected of having COVID-19 from coming to the ED. However, hospitals may use signage to direct individuals to certain locations within a hospital: e.g., if the hospital has set a dedicated location to triage potential COVID-19 patients.

Transfers of COVID-19 Patients to/from Hospitals: Hospitals with capacity and specialized capabilities needed to provide stabilizing treatment for COVID-19 are required to accept appropriate transfers from hospitals without such necessary capabilities. CMS reminds providers that this obligation applies to all Medicare-participating hospitals regardless of whether the recipient hospital has a dedicated ED. CMS encourages hospitals to coordinate with state/local public health officials.

COVID-19 Screening Locations (On-site): When patients come to the ED, a hospital may set up alternative medical screening examination screening locations for COVID-19 outside of the ED. After a patient is logged-in at the ED, a patient can be re-directed to these separate locations. CMS also notes that this initial patient logging and re-direction can also take place outside of the ED.

COVID-19 Screening Locations (Off-site):  Hospitals may also set up off-campus locations for influenza-like illness screening for COVID-19. CMS further notes that hospitals may encourage the public to go to these off-site locations rather than coming to the hospital to obtain screening for COVID-19. Such off-site locations cannot be held out as a location that provides emergency care (unless it is already a dedicated off-campus ED of the hospital). 

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Click here for NAEMSP's COVID-19 Resources.

Click here for more information regarding Advocacy.