Eight years after Congress passed its "anti-dumping" law, HCFA has issued final regulations implementing the measure, which is designed to curtail economically motivated transfers of hospital patients.
HCFA published the regulations in the June 22 Federal Register. They take effect 30 days after publication.
The 1986 law bars hospitals from transferring medically unstable patients or patients in active labor to other hospitals for economic reasons.
The law also requires hospitals to give basic medical screenings to all emergency department patients regardless of their ability to pay. And, it bars hospitals from delaying medical screenings to inquire about patients' insurance status.
Although HCFA has been enforcing the 1986 law through other legal authorities, consumer groups hope the issuance of the new regulations will lead to stepped-up enforcement efforts. The regulations formally codify the authority of HHS' inspector general's office to investigate and issue sanctions against hospital offenders.
Hospitals found in violation of the law can be fined up to $50,000 per violation and be terminated from the Medicare and Medicaid programs.
Last year, the Washington-based consumer group Public Citizen issued a report charging HCFA with being lax in enforcing the patient-dumping law. The report said the agency fined just 17 hospitals for dumping violations between 1986 and 1992. Another seven hospitals were expelled from Medicare, but four were later reinstated (May 24, 1993, p. 8).
Records compiled by MODERN HEALTHCARE show another eight hospitals have paid civil monetary penalties to the government since January 1993 to settle patient-dumping charges.
Public Citizen applauded the new regulations, saying they "could make a tremendous difference in providing the safety net Congress intended for all persons in need of emergency care."