EMTALA costs physicians billions in unreimbursed care

Doctors seek better compensation to make up for the bad debt they incur caring for patients in emergency settings.

By Markian Hawryluk, AMNews staff. June 2/9, 2003.

Washington -- For many physicians, the federal law that prevents patient "dumping" is a losing proposition.

A study released in May by the American Medical Association found that physicians lost $4.2 billion in revenue in 2001 providing care mandated by the Emergency Medical Treatment and Active Labor Act. The law requires doctors to screen and stabilize emergency patients regardless of whether they have health insurance or are able to pay for their care.

Physicians incurred an average of $12,300 each in bad debt attributable to EMTALA. This represented about 13.7% their total bad debt in 2001.

Emergency physicians bear the brunt of unreimbursed care stemming from the law. The study found that every emergency physician surveyed incurred EMTALA-related bad debt, averaging $138,300 in lost revenue. More than a third of emergency physicians provided more than 30 hours of EMTALA-related care each week.

Physicians in other specialties averaged less than six hours a week on care mandated by EMTALA, but there was wide variation in the amount of that care written off as bad debt.

More than 60% of internal medicine subspecialists and general surgeons surveyed indicated they had incurred at least some bad debt due to EMTALA. The average amount per doctor was more than $25,000 in 2001.

Fewer than 25% of pediatricians, psychiatrists, pathologists and other specialists incurred any bad debt from EMTALA.