While the current administration states that CMS will continue to enforce EMTALA requirements, the rescinding of the aforementioned memo is part of a larger effort to reduce hospital compliance with the law and limit regulation. Reducing enforcement of the EMTALA will have potentially devastating effects on reproductive health, particularly among patients who are from marginalized and medically underserved communities. If hospitals do not comply with the screening, stabilizing, and transfer requirements, patients may be discriminated against, denied care, or their safety may be put in jeopardy if transferred to other care settings without proper evaluation or treatment. Limiting oversight of hospital compliance with non-discrimination requirements will open the door for potentially devastating morbidity or mortality amongst vulnerable communities.
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A written policy statement issued by a government agency or executive official that provides guidance, clarification, or direction on implementing laws or policies. Memos do not have the force of law but can influence policy interpretation and enforcement.
Who It Impacts: Federal agencies, policymakers, and sometimes regulated industries. Memos can shape how agencies enforce laws, impacting businesses, healthcare providers, and other stakeholders.
Who Is Not Impacted: Memos do not create binding legal requirements for the general public, though they can influence enforcement priorities that indirectly affect individuals and organizations.
Summary
This federal action applies to the Department of Health and Human Services (HHS) and Centers for Medicare and Medicaid Service (CMS). It rescinds the agency’s July 2022 guidance titled “Reinforcement of EMTALA Obligations specific to Patients who are Pregnant or are Experiencing Pregnancy Loss” and the accompanying Letter from the former HHS Secretary. The Emergency Medical Treatment and Labor Act (EMTALA), encoded in the Social Security Act, outlines three requirements for hospital emergency departments: 1. all individuals are entitled to a medical screening examination in emergency settings, 2. individuals are entitled to stabilizing treatment, and 3. individuals may only be transferred to other hospitals if they are appropriately stabilized. The original memo emphasized specific provisions regarding hospital requirements, and it was rescinded under the stipulation of consistency with Executive Order 14192 “Unleashing Prosperity Through Deregulation”.
Impact Analysis
Legal Challenges
Take Institutional Action
- Institutions should continue to uphold EMTALA requirements and ensure internal and partner compliance with relevant Social Security policy provisions, even in light of changes to federal guidance.
- Patient advocacy organizations should equip patients and their support teams with information on their health care rights, including the right to file a complaint if they have concerns about the quality of care received at a health care facility receiving federal funds. Complaints regarding EMTALA compliance can be submitted through the CMS website: https://www.cms.gov/medicare/health-safety-standards/quality-safety-oversight-general-information/contact-information.
Associated or Derivative Policies
Executive Order 14192 “Unleashing Prosperity Through Deregulation”
Policy Prior to 2025
State Operations Manual Appendix V – Interpretive Guidelines – Responsibilities of Medicare Participating Hospitals in Emergency Cases
