In the five years from 1996 through 2000, U.S. hospitals violated federal law at least 975 times by failing to appropriately screen, treat or transfer patients arriving at their emergency rooms, according to a new report.
What's more, the number of confirmed violations has increased dramatically over the years, despite a steep increase in civil monetary penalties, according to the 146-page report by the health research group of Public Citizen, a Washington-based consumer advocacy group.
The group released its report about two weeks after the General Accounting Office said confusing regulations and court rulings have led providers into inadvertently violating the dumping law (July 2, p. 4). At that point, Public Citizen said it hoped the GAO report wouldn't water down federal fraud enforcement efforts.
The 975 violations confirmed by the Centers for Medicare and Medicaid Services occurred at 527 hospitals, or about 10% of U.S. hospitals, in 46 states, according to the Public Citizen report. In 13 instances, physicians were specifically cited. The majority of hospitals cited, 72.5%, were not-for-profit. Public Citizen said this report's findings bring to 1,906 total confirmed violations of the Emergency Medical Treatment and Active Labor Act by hospitals and physicians since the law's passage in 1986.
Although for-profit hospitals accounted for fewer violations, they were disproportionately represented based on their percentage of the industry and 1.7 times more likely to violate the law, according to Public Citizen. CMS cited 104 for-profit hospitals from 1996 to 2000 for violations of the emergency act; the tax status of 8% of violators was not known.
Chip Kahn, president of the Federation of American Hospitals, which represents the for-profit hospital industry, disputed the finding that for-profit hospitals were more likely to violate the law and said it was unfortunate the report distinguished hospitals by their profit status.