8 Ways On-Call Physicians Can Get Cited With an EMTALA Violation

There are a lot of good resources regarding EMTALA and on-call. Medlaw Attorney Stephen Frew published an article about “…common practices that will get on-call physicians cited” here are some great excerpts from that article.

    1. If an on-call Doctor is asked to see a patient in the ED and the Doctor responds with, do this, this and this, and I will see the patient at a later time.
    2. When the on-call Doctor is asked to see an ED patient and the Doctor refuses and suggests that the patient be seen by another specialist.
    3. When covering more than one hospital on-call, asking a patient to be sent to the hospital where the on-call physician is currently seeing patients instead of going to the patient’s location.
    4. When asked to come in to see an E.D. patient, declining on the basis that the specialist physician is “not interested” in a case of that type.
    5. Refusing to participate in the call list which then leads to gaps in the list, but expecting to be called for your own patients and for patients of physicians for whom you are covering.
    6. Refusing to be listed individually on the call list and insisting that only the group or answering service name and number be listed.
    7. Listing only your PA or NP on the call roster instead of the on-call physician.
    8. Insisting that calls must come from the ED physician or qualified medical provider when contacted by a nurse or other person on behalf of the ED physician.
    9. EMTALA penalties for on-call physicians:

Like hospitals, on-call physicians who violate their EMTALA obligations face a number of enforcement provisions. A failure to comply with federal and state laws and their accompanying regulations — including EMTALA — may result in termination from the Medicare and Medicaid programs.

The Office of Inspector General (OIG) may issue civil monetary penalties (CMPs) and exclude physicians from federal health care programs as well. CMPs range from up to $25,000 per violation for hospitals with fewer than 100 beds to $50,000 per violation for hospitals with 100 beds or over. Penalties are based on the size of the facility. The OIG can also assess up to $50,000 per violation for physicians who commit gross and flagrant violations.

This list is not inclusive and should not be considered legal advice.

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