Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 31 - Emergency Medical Services › Chapter 10 - Critical Care Paramedic › Appendix 15-12-31-10-7 - RELATED COBRA REGULATIONS H.R. 3128-83 Subpart B-Miscellaneous Provisions Sec. 9121. Responsibilities of Medicare Hospitals in Emergency Cases

Current through June 25, 2024
Requirement of Medicare Hospital Provider
					 Agreements.-Section 1866(a)(1) of the Social Security Act (
					 42 USC
					 1395 cc (a)(1) is amended-
by striking out "and" at the end of subparagraph (G),
by striking out the period at the end of subparagraph (H)
					 and inserting in lieu thereof", and ", and
by inserting after subparagraph (H) the following new
					 subparagraph: "(I) in the case of a hospital, to comply with the requirements
					 of section 1867 to the extent applicable."
Requirements-Title XVIII of such Act is amended by
					 inserting after section 1866 the following new section:
Examination and Treatment for Emergency Medical Conditions
					 and Women in Active Labor: "Spec. 1867 (a) Medical Screening Requirement.-In
					 the case of a hospital that has a hospital emergency department, if any
					 individual (whether or not eligible for benefits under this title) comes to the
					 emergency department and a request is made on the individual's behalf for
					 examination or treatment for a medical condition, the hospital must provide for
					 an appropriate medical screening examination within the capability of the
					 hospital's emergency department to determine whether or not an emergency
					 medical condition (within the meaning of subsection (3)(1) exists or to
					 determine if the individual is in active labor (within the meaning of
					 subsection (e)(2)).
Necessary Stabilizing Treatment for Emergency Medical
					 Conditions and Active Labor.- In general.-If any individual (whether or not
					 eligible for benefits under this title) comes to a hospital and the hospital
					 determines that the individual has an emergency medical condition or is in
					 active labor, the hospital must provide either-within the staff and facilities
					 available at the hospital, for such further medical examination and such
					 treatment as may be required to stabilize the medical condition or to provide
					 for treatment of the labor, or for transfer of the individual to another
					 medical facility in accordance with subsection (c).
Refusal to Consent to Treatment - A hospital is deemed to
					 meet the requirement of paragraph (1)(A) with respect to an individual if the
					 hospital offers the individual the further medical examination and treatment
					 described in that paragraph but the individual (or a legally responsible person
					 acting on the individual's behalf) refuses to consent to the examination or
					 treatment.
H.R.3128-84
Refusal to Consent to Transfer - A hospital is deemed to
					 meet the requirement of paragraph (1) with respect to an individual if the
					 hospital offers to transfer the individual to another medical facility in
					 accordance with subsection (c) but the individual (or a legally responsible
					 person acting on the individual's behalf) refuses to consent to the
					 transfer.
Restricting Transfers Until Patient Stabilized
-
Rule. - If a patient at a hospital has an emergency medical
					 condition which has not been stabilized (with the meaning of subsection
					 (e)(4)(B) or is in active labor, the hospital may transfer the patient
					 unless-(i) the patient (or a legally responsible person acting on the patient's
					 behalf) requests that the transfer be effected, or a physician (within the
					 meaning of section 1861(r)(1), or other qualified medical personnel when a
					 physician is not readily available in the emergency department, has signed a
					 certification that, based upon the reasonable risks and benefits to the
					 patient, and based upon the information available at the time, the medical
					 benefits reasonably expected from the provision of appropriate medical
					 treatment at another medical facility outweigh the increased risks to the
					 individual's medical condition from effecting the transfer; and
in which the transferring hospital provides the receiving
					 facility with appropriate medical records (or copies thereof) of the
					 examination and treatment effected at the transferring hospital;
in which the transfer is effected through qualified
					 personnel and transportation equipment, as required including the use of
					 necessary and medically appropriate life support measures during the transfer;
					 and
which meets such other requirements as the Secretary may
					 find necessary in the interest of the health and safety of patients
					 transferred.
Enforcement-
As Requirement of Medicare Provider Agreement. - If a
					 hospital knowingly and willfully, or negligently, fails to meet the
					 requirements of this section, such hospital is subject to-termination of its
					 provider agreement under this title in accordance with section 1866(b),
					 or
at the option of the Secretary, suspension of such
					 agreement for such period of time as the Secretary determines to be
					 appropriate, upon reasonable notice to the hospital and to the public.
Civil Monetary Penalties. - In addition to the other
					 grounds for imposition of a civil money penalty under section 1128A(a), a
					 participating hospital that knowingly violates a requirement of this section
					 and the responsible physician in the hospital with respect to such a violation
					 are each subject, under that section, to a civil money penalty of not more than
					 $25,000 for each such violation. As used in the previous sentence, the term
					 "responsible physician" means, with respect to a hospital's, a physician who-
					 is employed by, or under contract with, the participating hospital, and
acting as such an employee or under such a contract, has
					 professional responsibility for the provision of examinations or treatments for
					 the individual, or transfers of the individual, with respect to which the
					 violation occurred.
Civil Enforcement-
Personal Harm.- Any individual who suffers personal harm as
					 a direct result of a participating hospital's violation of a requirement of
					 this section may, in a civil action against the participating hospital, obtain
					 those damages available for personal injury under the law of the State in which
					 the hospital is located, and such equitable relief as appropriate.
Financial Loss To Other Medical Facility.- Any medical
					 facility that suffers a financial loss as a direct result of participating
					 hospital's violation of a requirement of this section may, in a civil action
					 against the participating hospital, obtain those damages available for
					 financial loss, under the law of the State in which the hospital is located,
					 and such equitable relief as is appropriate.
Limitations On Actions.- No action may be brought under
					 this paragraph more than two years after the date of the violation with respect
					 to which the action is brought.
Definitions.- In this section:
The term `emergency medical condition' means a medical
					 condition manifesting itself by acute symptoms of sufficient severity
					 (including severe pain) such that a prudent layperson, who possesses an average
					 knowledge of health and medicine, could reasonably expect the absence of
					 immediate medical attention to result in placing the health of the individual
					 (or with respect to a pregnant woman, the health of the woman or her unborn
					 child) in serious jeopardy, serious impairment of bodily functions, or serious
					 dysfunction of any bodily organ or part.
The term `participating hospital' means hospital that has
					 entered into a provider agreement under section 1866 and has, under the
					 agreement, obligated itself to comply with the requirements of this
					 section.
(A) The term `to stabilize' means, with respect to an
					 emergency medical condition, to provide such medical treatment of the condition
					 as may be necessary to assure, within reasonable medical probability, that no
					 material deterioration of the condition is likely to result from the transfer
					 of the individual from a facility.
The term `stabilized' means with respect to an emergency
					 medical condition, that no material deterioration of the condition is likely,
					 within reasonable medical probability, to result from the transfer of the
					 individual from a facility.
The term `transfer' means the movement (including the
					 discharge) of a patient outside a hospital's facilities at the direction of any
					 person employed by (or affiliated or associated, directly or indirectly, with)
					 the hospital, but does not include such movement of a patient who (A) has been
					 declared dead, or (B) leaves the facility without the permission of any such
					 person.
Preemption.- The provisions of this section do not preempt
					 any State or local law requirement, except to the extent that the requirement
					 directly conflicts with a requirement of this section.
Effective Date.- The amendments made by this section shall
					 take effect on the first day of the first month that begins at least 90 days
					 after the date of the enactment of this Act.
Report.- The Secretary of Health and Human Services shall,
					 not later than 6 months after the effective date described in subsection (c),
					 report to Congress on the methods to be used for monitoring and enforcing
					 compliance with section 1867 of the Social Security Act.
Sec. 9122. Requirement For Medicare Hospitals for
					 Participate In Champus and Champva Programs.
In General.- Section 1866(a)(1) of the Social Security Act
					 (
					 42 U.S.C.
					 1395 cc(a)(1) is amended-
by striking out "and" at the end of subparagraph
					 (H),
by striking out the period at the end of subparagraph (I)
					 and inserting in lieu thereof", and", and
by inserting after subparagraph (I) the following new
					 subparagraph:
in the case of hospitals which provide inpatient hospital
					 services for which payment may be made under this title, to be a participating
					 provider of medical care under any health plan contracted for under section
					 1079 or 1086 of title 10, or under section 613 of title 38, United States Code,
					 in accordance with admission practices, payment methodology, and amounts as
					 prescribed under joint regulations issued by the Secretary and by the
					 Secretaries of Defense and Transportation, in implementation of sections 1079
					 and 1086 of title 10, United States Code."
Effective Date.- The amendments made by subsection (a)
					 shall apply to agreements entered into our renewed on or after the date of the
					 enactment of this Act, but shall apply only to inpatient hospital services
					 provided pursuant to admissions to hospitals occurring on or after January 1,
					 1987.
Reference to Study Required.- For a study of the use by
					 Champus of the Medicare prospective payment system, see section 634 of the
					 Department of Defense Authorization Act, 1985 (
					 Public Law
					 98-525 ), the deadline for which is extended under
					 section 2002 of this Act.
Report.- The Secretary of Health and Human Services shall
					 report to Congress periodically on the number of hospitals that have terminated
					 or failed to renew an agreement under section 1866 of the Social Security Act
					 as a result of the additional conditions imposed under the amendments made by
					 subsection(a).
Miss. Code
					 Ann.§
											41-59-5