ARIZONA STATE SENATE
Phoenix, Arizona
hospitals; emergency
services
Purpose
Requires general hospitals, rural general hospitals and certain special hospitals to provide emergency services 24 hours a day, 7 days a week in a designated hospital area.
Background
Under the federal Emergency
Medical Treatment and Labor Act (EMTALA), general hospitals must provide
emergency screening and stabilization services to all patients regardless of
the patient’s ability to pay. Statute
further denies hospitals the ability to limit or restrict a patient's access to
medically necessary emergency services based on the patient's enrollment in a
health care services plan (A.R.S. § 20-2803).
According to the Arizona Hospital and Healthcare Association (AzHHA),
hospitals subject to EMTALA absorb the cost of services provided to patients who cannot pay, are uninsured or for whom insurers
deny payment. Special hospitals, however, are not subject to EMTALA and are not
required by the Department of Health Services (DHS) to provide emergency
services. S.B. 1341 requires general
hospitals, rural general hospitals and some special hospitals to provide
emergency medical services 24 hours a day, 7 days a week.
According to AzHHA, ambulatory surgery centers (ASC), also known as outpatient surgery centers, provide outpatient surgery and cannot keep patients overnight (beyond 24 hours). Medicare and some private insurers will not pay for ASC services that result in overnight stays in a recovery care center. As a result, some ASCs seek special hospital designation. To qualify for reimbursement, Medicare requires an ASC to have either a transfer agreement with a general hospital providing emergency services or cross membership of medical staffs. S.B. 1341 requires ASCs to have an effective procedure for the immediate transfer to a hospital that provides emergency services.
Finally, S.B. 1341 requires
DHS to adopt rules for the provisions of emergency services and requires
information to be made available upon request.
DHS is unaware of any cost associated with this bill.
1. Requires general hospitals, rural general hospitals and special hospitals to provide emergency services on a 24-hour, 7-day per week basis in a designated hospital area in accordance with rules adopted by DHS and federal law.
2. Requires emergency services provided by general hospitals, rural general hospitals and special hospitals to include:
a.
The
immediate availability of a physician who is qualified to provide emergency
services within the hospital (for rural hospitals the physician must be
available within 15 minutes).
b.
Maintain
a roster of on-call medical staff members.
c.
Implement
procedures to minimize a patient’s risk until the patient is transported or
transferred to another hospital if emergency services cannot be provided.
3. Requires DHS to adopt rules for the provision of emergency services to provide: (a) medical direction; (b) document of services provided; (c) the provision of emergency services on request; (d) provisions for the transport or transfer of patients; and (e) the maintenance of a roster of on-call medical staff.
4. Exempts from the emergency services requirements special hospitals that provide only psychiatric, rehabilitative or pediatric services or are located on the campus of a general hospital.
5. Requires an outpatient surgical center to maintain an effective procedure for the immediate transfer to a hospital that provides emergency services and policies for the transfer of patients requiring emergency care beyond its capabilities.
6. Provides definitions.
7. Provides for a general effective date.
Amendments
Adopted by Committee
1. Eliminates the requirement of a special hospital and an outpatient surgery center to maintain a transfer agreement or physicians performing procedures at its center to maintain privileges at general hospitals that provide emergency services.
2. Makes a conforming change.
Amendments
Adopted by Committee of the Whole
· Eliminates the exemption from the emergency services requirement for a special hospital operated by an entity that operates at least one general hospital within the same county.
Senate Action
HEA 3/12/02 DPA 6-0-2
3rd Read 4/1/02
22-5-3
Prepared by Senate Staff
April 3, 2002