I

106TH CONGRESS

2D SESSION H. R. 5304

To require the General Accounting Office to report on the impact of the

Emergency Medical Treatment and Active Labor Act (EMTALA) on

hospital emergency departments.

IN THE HOUSE OF REPRESENTATIVES

SEPTEMBER 26, 2000

Mr. SHADEGG introduced the following bill; which was referred to the Committee on Commerce, and in addition to the Committee on Ways and

Means, for a period to be subsequently determined by the Speaker, in

each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

A BILL

To require the General Accounting Office to report on the

impact of the Emergency Medical Treatment and Active

Labor Act (EMTALA) on hospital emergency departments.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Phoenix-Area Hospital

5 and Physician Assistance Act of 2000’’.

6 SEC. 2. FINDINGS.

7 The Congress makes the following findings:
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1 (1) The Emergency Medical Treatment and Ac2 tive Labor Act (EMTALA) requires that hospitals

3 and the emergency physicians as well as doctors on

4 call at hospital emergency departments screen and

5 stabilize patients who go to emergency departments

6 for treatment.

7 (2) Physicians who refuse to treat emergency

8 department patients or fail to respond to hospital

9 emergency department requests when on call face

10 significant fines and are exposed to liability under

11 EMTALA.

12 (3) Estimates indicate that EMTALA costs

13 emergency department physicians $426,000,000 per

14 year and leads to at least $10,000,000,000 more in

15 uncompensated inpatient services.

16 (4) Emergency departments, emergency physi17 cians, and physicians covering emergency depart18 ment call have become the de facto providers of indi19 gent health care in America.

20 (5) 27 percent of the over 4,300,000 people liv21 ing in Arizona are uninsured.

22 (6) Many physicians covering emergency de23 partment call in Phoenix, Arizona, are resigning

24 from the medical staff at hospitals due to burden25 some on-call requirements and uncompensated care.
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1 (7) Significant concern exists as to whether

2 downtown Phoenix hospitals can keep their emer3 gency departments open.

4 (8) The cumulative effect of potential hospital

5 closings and staff resignations threatens the quality

6 of health care in Phoenix, Arizona.

7 SEC. 3. REPORT ON EFFECT OF EMTATLA.

8 (a) REPORT.—The Comptroller General of the

9 United States shall submit a report to the Subcommittee

10 on Health and Environment of the Committee on Com11 merce of the House of Representatives by May 1, 2001,

12 on the effect of the Emergency Medical Treatment and

13 Active Labor Act on hospitals, emergency physicians, and

14 physicians covering emergency department call, focusing

15 on those in Phoenix, Arizona.

16 (b) REPORT REQUIREMENTS.—The report should

17 evaluate—

18 (1) the extent to which hospitals, emergency

19 physicians, and physicians covering emergency de20 partment call provide uncompensated services in re21 lation to the requirements of EMTALA;

22 (2) the extent to which the requirements of

23 EMTALA are having a deleterious effect on the leg24 islation’s original intent;
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1 (3) any possible estimates for the total dollar

2 amount EMTALA-related care costs emergency phy3 sicians, physicians covering emergency department

4 call, and hospital emergency department depart5 ments;

6 (4) the extent to which different portions of the

7 country may be experiencing similar uncompensated

8 EMTALA-related care;

9 (5) the extent to which EMTALA would be

10 classified as an unfunded mandate;

11 (6) the extent to which States have programs to

12 provide financial support for uncompensated care;

13 (7) the extent to which funds under medicare

14 hospital bad debt accounts are available to under15 write the cost of uncompensated EMTALA-related

16 care; and

17 (8) the financial strain that illegal immigration

18 populations place on hospital emergency depart19 ments.

20 (c) DEFINITION.—In this Act, the terms ‘‘Emergency

21 Medical Treatment and Active Labor Act’’ and

22 ‘‘EMTALA’’ mean section 1867 of the Social Security Act

23 (42 U.S.C. 1395dd).

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