"The purpose of this inspection was to evaluate the enforcement process for the Emergency Medical Treatment and Labor Act (EMTALA). [...] Congress created a bifurcated enforcement mechanism for EMTALA within the Department of Health and Human Services. The Health Care Financing Administration (HCFA) authorizes investigations of dumping complaints by State survey agencies, determines if a violation occurred, and, if appropriate, terminates a hospital's provider agreement. The Office of Inspector General (OIG) assesses civil monetary penalties against hospitals and physicians and may exclude physicians from the Medicare program for repeated or gross and flagrant behavior. The HCFA 'may' seek the input of the local peer review organization (PRO) after the State's investigation to help determine whether the hospital adequately screened, examined, and treated a patient but 'must' seek PRO input in most circumstances before forwarding a case to the OIG if the alleged violation involves a question of medical judgment."
Department of Health and Human Services, Office of Inspector General, Report No. OEI-09-98-00221
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