COBRA law damages health care system

Article Abstract:

Congress passed the 1986 Consolidated Omnibus Budget Reconciliation Act (COBRA) in part to prevent hospitals from rejecting emergency patients who could not pay, but the law is poorly tailored to address the problem of patient dumping. COBRA and associated regulations make hospitals follow detailed procedures and fill out extensive paperwork in many unnecessary cases, and apply potentially huge penalties for technical infractions. The law conflicts with the need to reduce costs by restricting non-emergency use of emergency rooms; it is clumsy and dangerous, and should be changed.

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EMTALA claims need no proof of improper motive; high court says plaintiffs suing hospitals under Emergency Medical Treatment and Active Labor Act need no bad-intent proof

Article Abstract:

Emergency Medical Treatment and Active Labor Act (EMTALA) cases used to have to show evidence that a hospital had an improper motive such as indigence or the patient's race ir sex when it violated the stabilization portion of the act, but after the Supreme Court's 1999 ruling in Roberts v. Galen of Virginia, Inc., evidence of such a motive will no longer be necessary. Hospitals should, however, not delay with necessary stabilizing examinations by asking about the patient's ability to pay for care. Some observers state that EMTALA filings will increase as a result of this ruling.

United States, Discrimination in medical care, Medical care discrimination

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Unwary hospitals may face the sharp fangs of COBRA; because penalties for violations are severe, hospitals must use caution in transferring or discharging their emergency room patients

Article Abstract:

The Consolidated Omnibus Budget Reconciliation Act includes language, most recently modified July 22, 1994, mandating many hospital procedures in minute detail. Hospitals must tailor their forms and procedures to comply with COBRA and reflect its language, or face draconian reprisals. The act forces hospitals and doctors to become informants regarding even technical violations. Steps to comply with important elements are discussed.

Hospitals, Hospital emergency services

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