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EMTALA was enacted in 1986 in response to reports of hospital emergency rooms refusing to treat indigent, uninsured patients without first assessing and/or stabilizing the patient’s condition, colloquially known as “patient dumping.” See 68 F.R. 53,222, 53,223 (Sept. 9, 2003); see also H.R. Rep. No. 99-241, pt.3, at 27 (July 31, 1985), reprinted in 1986 U.S.C.C.A.N. 579, 605 (indicating that Congress was “greatly concerned about the increasing number of reports that hospital emergency rooms are refusing to accept or treat patients with emergency conditions if the patient does not have medical insurance”).

Although EMTALA was enacted in response to perceived “patient dumping” of uninsured patients, EMTALA has generally not been interpreted to apply only to persons who are indigent or not capable of paying for care. The Supreme Court of the United States in Roberts v. Galen of Virginia, Inc., 525 U.S. 249 (1999) held that EMTALA’s stabilization requirement applies regardless of the hospital’s underlying motivation in transferring or discharging a patient. As such it will not be a cognizable defense to an EMTALA claim to argue that there is a lack of discriminatory motive based on the financial status of the patient.

There are two primary operative provisions of EMTALA that impose separate and distinct obligations on hospitals with respect to individuals who come to a hospital’s emergency room for care.

Screening Requirements

Stabilization Requirements

The Inpatient Conundrum