One of my most vivid childhood memories was when, as a teenager, I broke my arm playing softball at school. The pain was excruciating, but it was the quest to get medical treatment for my fractured appendage that is most memorable. The private hospital closest to my school in South Central Los Angeles turned my mother and me away because I had no medical insurance.  As a consequence, with my arm resting on a clipboard, we had to take a very long bus ride to the county hospital in East Los Angeles where I finally received treatment after enduring many hours of extreme pain.

Our federal government came to the rescue for people like me by passing the Emergency Medical Treatment and Active Labor Act (EMTALA). Enacted in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act,  EMTALA requires Medicare-participating hospitals to treat people needing emergency care without regard to their medical insurance status or ability to pay. This law also requires hospitals to accept transfers of emergency patients regardless of their medical insurance status if the care needed is not provided by the hospitals to which the patients were taken. A more stringent state law was enacted soon thereafter that mimicked EMTALA except it applied to all hospitals licensed to provide emergency medical services.  Fines for breaching these requirements can be as much as $50,000 per incident.

But that was then and this is now. Back then, health plans pretty much included all the doctors and hospitals serving their regions in their provider networks. Not so now. Good or bad, Obamacare has ushered us into an era where controlling costs is done by our health plans deploying increasingly exclusive medical provider networks, which will expose consumers to increased cost sharing if and when in emergency situations they find themselves being treated by non-contracting doctors and hospitals.

EMTALA and California laws need updating where hospital-to-hospital transfer of emergency patients is concerned. Unlike in 1986 when the remedy was implemented, today most of us with medical insurance share in the cost of the medical care we receive. And our share is even greater when we are cared for by doctors and hospitals that are not contracted with our health insurance plans.

These laws should be changed so that when patients must be transferred from one hospital to another providing the “higher level of care” required, staff at both hospitals can work together to match patients with hospitals participating in the network developed by their health plans. Otherwise, transferring patients from one hospital to the nearest hospital capable of providing the medical treatment needed may not be in the patients’ best interest, especially if their treating physicians determine patients can be safely transported to participating network hospitals. Your thoughts?