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Individual physician penalties resulting from violation of EMTALA: A review of Office of the Inspector General patient dumping settlements, 2002-2015.
Acad Emerg Med. 2017 Jan 20;:
Authors: Terp S, Wang B, Raffetto B, Seabury SA, Menchine M
Abstract
OBJECTIVE: To describe characteristics of civil monetary penalty settlements levied by the Office of the Inspector General (OIG) against individual physicians related to violation of the Emergency Medical Treatment and Labor Act (EMTALA).
METHODS: Descriptions of all civil monetary penalty settlements between 2002 and 2015 were obtained from the OIG. Characteristics of settlements against individual physicians related to EMTALA violations were described including settlement date, location, amount, whether there was an associated hospital settlement, the medical specialty of the physician involved, and the nature of the allegation.
RESULTS: Of 196 OIG civil monetary penalty settlements related to EMTALA, 8 (4%) were levied against individual physicians, and 188 (96%) against facilities. Seven of the 8 penalties against individual physicians were imposed upon on-call specialists, including 6 who failed to respond to evaluate and treat a patient in the emergency department, and one who failed to accept appropriate transfer of a patient requiring higher level of care. The only penalty imposed upon an emergency physician involved a case where a provider repeatedly failed to provide a medical screening exam to a pregnant teen based upon the erroneous belief that a minor could not be evaluated or treated absent parental consent. Four of 8 penalties against individual physicians were levied within the first three years of the fourteen-year study period. Half of all physician settlements were associated with a separate hospital civil monetary penalty settlement.
CONCLUSIONS: For emergency physicians, a civil monetary penalty is a feared consequence of EMTALA enforcement, as a physician can be held individually liable for fine of up to $50,000 not covered by malpractice insurance. Though EMTALA is an actively enforced law, and violation of the EMTALA statute often results in hospital citations and fines, and even facility closure, we found that individual physicians are rarely penalized by OIG following EMTALA violation. Individual physician penalties are far less common than hospital citations or fines related to EMTALA, or malpractice claims or payments. The majority of penalties against individual physicians were levied upon on-call specialists who refused to evaluate and treat emergency department patients. Only one emergency physician was fined during the study period for a clear violation of the EMTALA statute. Physicians should be diligent to ensure appropriate patient care and that facilities are compliant with the EMTALA statute, but should be aware that settlements against individual physicians are a rare consequence of EMTALA enforcement. This article is protected by copyright. All rights reserved.
PMID: 28109011 [PubMed - as supplied by publisher]