It’s a common thought that goes through the mind of uninsured or underinsured consumers with unpaid medical bills. What will happen if I need to go to the emergency room again? Will they make me pay all of my unpaid medical bills before they treat me? Will a medical debt collector be there waiting for me? The answer is, it depends on your injuries, and it depends on the facility.
In non-emergency situations, private hospitals and other providers (walk-in emergency rooms like ER Doc) are usually allowed to turn away patients because of prior debt. They may also require that the patient pay a deposit before services will be provided. However, there may be “safety net” facilities nearby, such as a public hospital or a community health center that will take all patients regardless of prior medical debt or lack of insurance.
The Emergency Medical Treatment and Active Labor Act (EMTALA)
In emergency situations, you should be able to obtain care from a hospital regardless of your prior unpaid medical bills under the Emergency Medical Treatment and Active Labor Act (EMTALA, 42 U.S.C. § 1395dd). EMTALA is a federal statute that prohibits hospitals from turning away a patient in need of emergency medical treatment because, among other things, the patient may not be able to pay for their care. EMTALA should also prohibit a hospital from turning away a patient in need of emergency treatment because of outstanding unpaid medical bills owed to a hospital. The EMTALA applies to private hospitals which accept Medicare or Medicaid, and to certain public hospitals. Medicaid itself also prohibits providers from denying services to Medicaid recipients on the basis of outstanding debts for co-payments or deductibles.
New York State Has an Emergency Admission Requirement that Enhances the EMTALA.
Under N.Y. Pub. Health Law § 2805-b, certain general hospitals may not transfer a medical debtor patient to another location due to his or her inability to pay prior outstanding medical bills. Violation of this section, or preventing the patient from access to required services, is a misdemeanor in New York.
What CAN a Hospital Do to a Medical Debtor Having a Medical Emergency?
Before treatment, New York hospitals can seek the signature of patients on consent forms that include a provision (usually hidden) requiring the patients’ agreement to pay for the medical care provided. Kolari v. N.Y. Presbyterian Hosp., 382 F. Supp. 2d 562 (S.D.N.Y. 2005), vacated in part on other grounds, 455 F.3d 118 (2d Cir. 2006). Hospitals are also allowed to employ reasonable registration processes, including asking medical debtors about prior unpaid medical bills, so long as the inquiry does not delay treatment or screening. But the hospital must treat the patient having a medical emergency. Note that the EMTALA in no way provides for free care—if an uninsured patient does receive treatment in an emergency, the patient may still be held liable for medical bills, and if the medical bills go unpaid, may be contacted by a debt collector trying to collect the medical debt in the future.
What If I Am Denied Treatment Because of My Unpaid Medical Bills?
Obviously finding immediate alternate treatment is the priority. Once your medical issues abate, you may have remedies available under New York state tort law, such as actual damages, attorney fees, and in some cases punitive damages. However, to qualify for these remedies, you must establish a “personal harm” from the hospital violating the EMTALA that would be compensable under New York state’s personal injury laws.
If you were NOT physically harmed by the hospital’s refusal to treat you, you still have options. You can challenge the hospital’s violation of the EMTALA under New York’s Deceptive Acts & Practices Act. If you are being sued by the hospital for unpaid medical bills and you were refused treatment at an emergency room because of your prior medical debt, a counterclaim may exist pursuant to the Emergency Medical Treatment and Active Labor Act (EMTALA).
The EMTALA provides for a private cause of action against hospitals, but not physicians, who violate its provisions. The Act also does not apply to ambulance service providers.
If you were denied treatment at a hospital in Nassau County or Suffolk County because of your unpaid medical bills, and you believe you were physically harmed as a result, than you should speak with a New York personal injury lawyer. I am NOT a personal injury lawyer. I am a New York Consumer Lawyer. I can help you if you were denied treatment due to unpaid medical bills, and you weren’t harmed at all. Contact me for your free consultation and see if I can help you.