Legal and Regulatory Update Includes EMTALA, Data Breaches, Medical Marijuana, and More

​The legal and regulatory challenges confronting healthcare risk managers' organizations range from ongoing issues, such as those arising from the Emergency Medical Treatment and Labor Act (EMTALA), to data breaches and potential new areas of liability such as those created by laws allowing the use of medical marijuana, said closing speakers at the October 7 through 10, 2018, American Society for Health Care Risk Management (ASHRM) annual conference in Nashville. A regular feature at the ASHRM meeting, the legal and regulatory update is provided by Daniel P. Groszkruger, JD, MPH, CPHRM, DFASHRM, principal, rskmgmt.inc, and Paul English Smith, JD, CPHRM, DFASHRM, general counsel and vice president, Cabell Huntington (West Virginia) Hospital. Regarding EMTALA, Smith commented on behavioral health cases arising in the emergency department (ED), including the largest reported EMTALA settlement of $1.3 million by a three-hospital system for holding patients with unstable psychiatric conditions involuntarily in its ED, despite the availability of on-call psychiatrists and psychiatric beds. The settlement covered 36 incidents involving ED stays from 6 to 38 days. The health system had a policy of not admitting involuntarily held patients to its psychiatric unit. In another EMTALA case, a hospital was fined $100,000 for failing to provide a screening exam and stabilizing treatment to two patients with elevated blood alcohol levels who had been brought to the ED for possible suicide attempts. The hospital discharged the patients to the police to send them to jail.