Emergency Care Rights
Written in plain language for general understanding. This is educational content, not legal advice. Based on federal statutes and official sources.
What is this right?
The Emergency Medical Treatment and Labor Act (EMTALA) is a federal law that requires every hospital with an emergency department that participates in Medicare to provide emergency care to anyone who comes through the door — regardless of their ability to pay, insurance status, citizenship, or any other factor.
Under EMTALA, the hospital must provide a medical screening examination to determine if you have an emergency medical condition. If you do, the hospital must stabilize your condition before discharging or transferring you. Hospitals that violate EMTALA face civil monetary penalties of up to $133,420 per violation (inflation-adjusted), and individual physicians can also be fined and excluded from Medicare.
When does it apply?
This right applies when:
- You go to a hospital emergency department — regardless of whether you have insurance, money, or identification
- You believe you are having a medical emergency (severe pain, difficulty breathing, chest pain, active labor, psychiatric crisis, etc.)
- A hospital tries to turn you away, asks about your ability to pay before screening you, or transfers you before stabilizing your condition
- You are in active labor — hospitals must deliver the baby and stabilize both mother and child
Common misconceptions:
- “The ER can refuse to see me if I don't have insurance” — Absolutely not. EMTALA requires screening and stabilization regardless of insurance or payment ability. The hospital can bill you afterward, but they cannot refuse to see you.
- “EMTALA means free healthcare” — EMTALA requires emergency screening and stabilization, not free care. You may still receive a bill after treatment. However, you cannot be turned away for inability to pay.
- “EMTALA covers all hospitals” — It applies only to hospitals that have emergency departments and participate in Medicare. This covers the vast majority of hospitals, but some small facilities and urgent care centers may not be covered.
- “They can transfer me to another hospital because I can't pay” — A hospital cannot transfer you until your condition is stabilized, unless you request the transfer or a physician certifies that the benefits of transfer outweigh the risks. This is called the anti-dumping provision.
What should you do?
Step 1: Go to the emergency room if you believe you have a medical emergency. You do not need insurance, ID, or money. Tell the triage staff your symptoms clearly.
Step 2: If staff asks about your insurance or ability to pay before examining you, say: “I need a medical screening examination. I understand I have a right to be screened under EMTALA.” The hospital must screen you before discussing payment.
Step 3: If the hospital tries to transfer you before stabilizing your condition, ask why and whether the transfer is medically necessary. You have the right to refuse a transfer. If you consent, the hospital must ensure the receiving facility has agreed to accept you and has the capacity to treat you.
Step 4: If you believe a hospital violated EMTALA, file a complaint with CMS at cms.gov or call 1-800-633-4227 (1-800-MEDICARE). You can also file a complaint with your state health department.
Step 5: You may have the right to sue the hospital under EMTALA's private right of action (42 U.S.C. § 1395dd(d)(2)). Contact a medical malpractice or patients' rights attorney. The statute of limitations is typically 2 years from the date of the violation.
What should you NOT do?
Don't leave the ER before being screened. If you walked in with an emergency complaint, do not leave against medical advice without being screened. If the wait is long, tell staff your symptoms are getting worse.
Don't let billing questions delay your care. The hospital can ask about insurance for record-keeping, but they cannot delay your screening or treatment because of billing. If you feel pressured, remind staff of your EMTALA rights.
Don't agree to a transfer you're uncomfortable with. If the hospital wants to transfer you before your condition is stable, you can refuse. If you do agree, make sure the receiving hospital has accepted you and can treat your condition.
Don't assume EMTALA covers follow-up care. EMTALA requires screening and stabilization of emergency conditions. Once you are stabilized and discharged, the hospital is not required to provide ongoing treatment under EMTALA. However, ask about financial assistance, charity care, and follow-up resources before you leave.
How New Jersey differs from federal law
New Jersey has additional emergency care protections that supplement federal EMTALA:
- NJ Hospital Licensing Standards (N.J.A.C. 8:43G): All licensed hospitals with emergency departments must provide care to anyone presenting with an emergency condition, regardless of insurance or payment ability. New Jersey enforces these standards through the Department of Health licensing process.
- NJ Out-of-Network Consumer Protection Act (P.L. 2018, c.32): Protects patients from surprise billing in emergency situations. Emergency patients treated by out-of-network providers cannot be balance billed — they only owe their in-network cost-sharing amount.
- NJ Charity Care (N.J.A.C. 10:52-11): All New Jersey hospitals must provide charity care to low-income patients. Patients with income below 200% FPL receive free care, and patients between 200 and 300% FPL receive reduced-cost care. Hospitals must inform emergency patients about charity care eligibility before pursuing collections.
- NJ FamilyCare emergency coverage: New Jersey's expanded Medicaid program covers emergency services. NJ also provides Emergency Medicaid for people who are income-eligible but excluded from regular Medicaid due to immigration status.
Additional Steps in New Jersey
File an EMTALA complaint with CMS at 1-800-633-4227. For state hospital complaints, contact the NJ Department of Health at nj.gov/health or call (800) 792-9770. For charity care assistance, contact the hospital's financial counselor or NJ Citizen Action at njcitizenaction.org. Contact Legal Services of NJ at lsnj.org for free legal help.
Relevant Law: N.J.A.C. 8:43G (hospital licensing), P.L. 2018, c.32 (Out-of-Network Consumer Protection Act), N.J.A.C. 10:52-11 (charity care), Federal EMTALA, 42 U.S.C. § 1395dd
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