Understanding the Rules
Being refused treatment while seeking immediate medical attention is every patient’s worst nightmare. If you’re sick, injured, or hurt, can a healthcare organization, like a private doctor, hospital, or family doctor’s office, refuse to treat you, even when you have health insurance? The answer, unfortunately, is yes.
Can a Hospital Refuse to Treat Patients?
While there is legislation that exists that requires hospitals to provide a certain standard of care to all patients, there are circ*mstances where legally, a hospital can refuse to treat patients for their medical conditions, even when they seek care through an emergency room.
However, these circ*mstances are not common, and it’s only in a few instances that healthcare providers can refuse to treat patients experiencing medical emergencies. If you are denied treatment outside these limited circ*mstances, you may be able to seek compensation through a medical malpractice lawsuit.
Can a Doctor Refuse to Provide Emergency Medical Treatment?
The Emergency Medical Treatment and Active Labor Act (EMTALA) is a federal law that requires hospitals with emergency departments to provide emergency treatment to anyone in need, regardless of their ability to pay.
The Emergency Medical Treatment and Active Labor Act was enacted to prevent hospitals from “patient dumping” or transferring an uninsured patient with emergency medical conditions to other facilities based on their inability to pay.
EMTALA mandates that hospitals conduct a medical screening examination to determine whether an emergency medical condition exists, and if so, provide stabilizing treatment or transfer the patient to another facility, such as an emergency department with the appropriate capabilities to handle their care. Emergency conditions include disruption of bodily function, injury, or severe illness.
What Emergency Medical Conditions are Covered Under the Act?
An emergency medical condition is defined as a condition that, if left untreated, could result in impairment or serious dysfunction of a patient’s bodily functions, organs, or body parts.
Failure to comply with EMTALA can result in severe penalties for the hospital, including fines and loss of Medicare funding. Additionally, hospitals that are found to be rejecting patients in patient dumping schemes can also face civil penalties and medical malpractice lawsuits.
Pregnancy and Labor
Active labor is considered its own emergency medical condition under the Act, which means that healthcare staff must provide medical treatment to address anything that is placing the unborn child’s health, the patient’s health, or both in serious jeopardy. Patients seeking treatment primarily for pregnancy-related emergency medical conditions are protected specifically against refusing treatment.
This means that in every circ*mstance, emergency care must be given to the woman and her child until labor is complete, stabilization and transfer to appropriate facilities can occur, or the contractions cease, which can be the case in ‘false labor’ cases when the contractions don’t actually signal that the baby is coming. This applies even to non-emergency medical settings, like private doctors’ offices or non-emergency departments within private hospitals.
When to Consider a Medical Malpractice Lawsuit
If a hospital refused to treat a patient, and the hospital’s refusal results in injury, harm, or even death, the hospital or healthcare or health insurance provider may be subject to a medical malpractice lawsuit. In such cases, the patient who was seeking emergency care or their family would need to prove that the hospital or doctor was negligent and that this negligence led to the harm that was suffered.
Consulting with a medical malpractice attorney can help determine if a case has merit and guide the patient’s health and or their family through the legal process. To establish a medical malpractice case, the plaintiff must demonstrate four elements:
- Duty of care: The healthcare provider owed the patient a duty to provide medical care according to the recognized standard.
- Breach of duty: The healthcare provider failed to meet the standard of care by refusing to provide treatment.
- Causation: The breach of duty directly caused the patient harm, either in injury or disruption of bodily function.
- Damages: Because of the refusal of treatment, the patient directly suffered harm as a result.
Are All Healthcare Facilities Required to Provide Emergency Medical Care?
While emergency rooms are required to provide emergency medical care under EMTALA, not all medical facilities are subject to the same regulations as an emergency room. Urgent care clinics, private doctors’ offices, and some private hospitals may not be required to provide emergency treatment to all patients.
These facilities and private doctors may be allowed to refuse treatment based on factors such as insurance status, inability to pay, or the nature of the patient’s condition. However, if a patient’s condition is life-threatening, even private facilities are obligated to provide at least stabilizing treatment before transferring the patient to an appropriate facility.
What Are the Exceptions to Providing Treatment?
There are certain exceptions when hospitals and doctors may be allowed to refuse treatment. These exceptions may include:
- Capacity: If a hospital is at capacity and cannot safely admit more patients, it may divert patients to other facilities with more room. However, there are state and federal legal limitations on how hospitals can divert patients, so they can’t just turn a patient back out onto the street.
- Medical instability: If a patient is deemed medically unstable due to factors such as intoxication, having a communicable disease, or experiencing a psychiatric disruption, the hospital must still provide care, but only if they have the resources to do so safely. Otherwise, the patient may be transferred to an urgent care clinic or another facility that is equipped to handle the patient’s needs.
- Persistent drug-seeking behavior: Hospitals and healthcare providers may refuse treatment if they believe a patient is exhibiting drug-seeking behavior or if the patient poses a threat to the safety of other patients or staff.
- Religious or conscientious beliefs: Healthcare providers may refuse treatment based on religious or conscientious beliefs, but they must still ensure the patient receives appropriate care from another provider.
What To Do if a Hospital Refuses To Treat You
Hospitals and emergency rooms are generally required to provide emergency treatment to patients, regardless of their ability to pay, their medical condition, or their insurance status under federal law. Understanding the legal requirements and exceptions for medical treatment is essential for patients to protect their rights.
If you believe you have been wrongfully refused treatment by a hospital or a doctor refused to treat you, it is crucial to consult with a medical malpractice attorney to discuss your case. An experienced attorney can help determine if your case has merit, guide you through the legal process, and represent you in court or during settlement negotiations.
It is important for patients to be aware of their rights and the limitations of medical facilities when seeking treatment. If a hospital or doctor’s office decided to not provide treatment, you may be entitled to compensation. We’re here to help: if you believe that you’ve been wrongfully refused treatment, call us at 816-542-6734 and one of our experienced attorneys will be happy to help walk you through your options.
