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Anti-Dumping Law

Inability to Pay

Patients cannot be denied emergency care due to the inability to pay. The Emergency Medical Treatment and Active Labor Act (EMTALA—Anti-Dumping Act) is a regulation that insures that patients with an emergency medical condition are assessed and treated at any hospital providing emergency services without consideration of ability to pay. The EMTALA also places certain conditions and responsibilities on interhospital transfers.


EMTALA applies to:

  • Hospitals receiving Medicare
  • Hospitals offering emergency care
  • Physicians providing services in such hospitals

General Regulations of EMTALA

  • Screening Examination – The hospital must provide a screening examination to any individual who arrives on hospital property requesting treatment.
  • Ability to Pay Must Not Interfere – No effort should be made to determine the patient's ability to pay for or cover the costs of EMTALA requirements.
  • Stabilization Requirement – The hospital must provide treatment within the capabilities of the staff to stabilize the condition or transfer the patient to another medical facility which can provide appropriate care.

Transfer Requirements

A patient may only be transferred if the emergency medical condition has been stabilized; if the transfer is requested in writing by the patient; or if a physician or a qualified medical person has signed a certification that the medical benefits outweigh the increased risks. The transferring physician is responsible for meeting the transfer requirements.

The transferring hospital must:

  • Be unable to provide the needed medical treatment
  • Send medical records related to the emergency condition
  • Transport the patient with the necessary medical equipment and personnel

The receiving facility must:

  • have available space for the patient
  • have qualified personnel for the treatment
  • agree to accept the individual

Unlawful Transfer or Refusal

If a patient has been unlawfully transferred, he or she may file a complaint with the Maryland Department of Health and Mental Hygiene or the Joint Commission for accreditation of hospitals.

A hospital that has specialized capabilities or facilities (including burn units, shock trauma units) may not refuse to accept a patient from a transferring hospital, if the receiving hospital has an available bed.