Payment for Emergency Medical Treatment and Labor Act (EMTALA) - Mandated Screening and Stabilization Services
Instructs that for an item or service provided by a hospital or critical access hospital pursuant to section 1867of the Social Security Act (EMTALA) on or after January 1, 2004, FIs must make determinations of whether the item or service is reasonable and necessary on the basis of information available to the
treating physician or practitioner (including the patient’s presenting symptoms or complaint) at the time the item or service was ordered or furnished by the physician or practitioner (and not only on the patient’s principal diagnosis). The frequency with which an item or service is provided to the patient before or after the time of the service shall not be a consideration.
Final
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: November 05, 2005
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.