Hospitals all over the country have been contacting me in recent days with the same question – the hospitals that receive require us to sign sketched transfer agreements. How is it going with EMTALA? Unfortunately, the answer is not clearly mentioned in EMTALA, but over the years, WSC representatives have expressed their views on the implementation of this issue, most often referring to the limitations of these agreements when it comes to EMTALA. Some states require that the hospital with which the CSA arranges transfers be within a certain csa travel time limit. For example, Illinois and Mississippi indicate 15 minutes, while Oklahoma indicates 20 minutes and Florida 30 minutes. transfer agreements should clearly define the respective responsibilities of the CSA and the hospital in a number of areas, including the provision of patient information; the provision of means of transport; sharing of services, equipment and personnel; the provision of care with regard to the establishment and capacity of the Agency; and confidentiality of medical records. Final Rule: CMS concludes revisions to Section 416.41(b)(3) to require CSAs to regularly provide the local hospital with written notification of its operation and patient population. For example, the notification would include details such as operating hours and procedures performed in the ASC. According to the CMS, written notification, instead of a transfer agreement, will reduce the administrative burden for negotiations or refusal to negotiate under the written transfer contract between the CSA and the hospital. I am not aware of any recent statements from CMS, but over the years, their position has generally favoured transfer agreements in order to facilitate the rapid and efficient flow of patients.
However, you were quick to stress that the existence or absence of a transfer agreement does not change the rules applicable to EMTALA transfers. The final rule relieves ASCs of CMS compliance with the legislation and allows them to work more independently and efficiently. Despite these changes, there may be reasons, from a licensing, risk management or operational perspective, to continue current practices in transfer agreements, H&Ps and emergency prevention. The full text of the final rule is available here. “The transfer contract is essentially the contingency planning document,” Litka-Klein said in the letter. Each CSA that treats Medicare beneficiaries must be certified by the Medicare program and, therefore, meet federal government requirements for CSAs. One of these requirements requires CSOs to have a written transfer agreement with a local Medicare participating hospital or a non-participating hospital that meets Medicare program requirements for emergency payments. If the CSA does not have a transfer agreement, any physician who performs an operation in the CSA must have privileges to be admitted to a designated CMS-compliant hospital. However, current issues focus on the topic of “backward transfer”.
In this regard, CMS has indicated in several of my cases that “Transfer Back” is an authorized provision in a transfer agreement, as long as three criteria are included: patients who arrive in the emergency department without an ASD transfer agreement may not have complete medical records and a hospital may not have the opportunity to access them quickly. According to Barbara Blackmond, a partner at Horty Springer & Mattern, a law firm representing hospitals. 1. CSOs must not have a written transfer or hospital planning agreement for all physicians. Centres must provide hospitals with a document containing information about their operation and patient population. . . .