Being Denied Emergency Medical Care in Illinois
I was denied emergency medical care — here's what Illinois law says and what to do next.
Statute: 215 ILCS 5/356z.3a et seq. (Network Adequacy and Transparency Act — specified state law)
Deadline: 120 days
Penalty: Illinois has a specified state law under the NSA. State-regulated plans use Illinois's dispute resolution process. Violations may result in federal penalties of up to $10,000 per violation and state enforcement
What is being denied emergency medical care?
The Emergency Medical Treatment and Labor Act passed in 1986 in direct response to a national pattern of "patient dumping" — uninsured emergency patients turned away at the door, or shipped off to other hospitals before they were stabilized. The most notorious case involved a woman in active labor in Chicago who was refused care at one hospital and delivered her baby in the back of a transferring ambulance. The baby didn't survive.
EMTALA requires every Medicare-participating hospital with an emergency department to provide a medical screening examination for anyone who walks in — regardless of ability to pay, insurance, immigration status, or anything else. If they have an emergency medical condition, the hospital must stabilize them before discharge or transfer. Penalties scale up to $133,420 per violation for hospitals with 100+ beds (inflation-adjusted from the original $50,000), and physicians can be personally fined and excluded from Medicare. EMTALA also has a private right of action — patients can sue.
What to Do If a Hospital Refuses to Treat You in an Emergency
Step 1: Go to the ER if you believe you have an emergency. No insurance, no ID, no money — none of it matters under EMTALA. Tell triage your symptoms clearly and concisely.
Step 2: If asked about payment first, invoke EMTALA out loud. "I need a medical screening examination. I have a right to be screened under EMTALA." The hospital must screen before discussing payment.
Step 3: Question any transfer. If they try to transfer you before stabilizing, ask why and whether it's medically necessary. You can refuse the transfer. If you consent, the hospital must confirm the receiving facility has agreed to accept you and can treat your condition.
Step 4: Complain to CMS. Federally, file at cms.gov or call 1-800-633-4227 (1-800-MEDICARE). You can also file with your state health department, which often investigates faster.
Step 5: Sue under the private right of action. 42 U.S.C. § 1395dd(d)(2) lets EMTALA-violation victims sue the hospital for damages. The limitations period is typically 2 years from the violation. Medical malpractice or patients' rights attorneys take these on contingency.
How Illinois differs from federal law
Illinois supplements federal EMTALA with state-level emergency care protections:
- Illinois Hospital Licensing Act (210 ILCS 85/11.8): Requires all hospitals to provide emergency care regardless of the patient's ability to pay, mirroring EMTALA at the state level.
- Financial assistance requirements: Illinois mandates that all hospitals maintain financial assistance policies and notify patients of their availability. Illinois requires hospitals to screen patients for eligibility before pursuing collections.
- Uninsured Patient Discount Act: Requires hospitals to offer discounts to uninsured patients and limits what they can charge to no more than the amount insurance companies typically pay.
- Medical debt protections: Illinois law restricts hospitals from reporting medical debt to credit bureaus until they have made reasonable efforts to determine if the patient qualifies for financial assistance.
Additional steps in Illinois
File an EMTALA complaint with CMS at 1-800-633-4227. File state complaints with the Illinois Department of Public Health. Contact Legal Aid Chicago for help with medical billing disputes.
What you should 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.
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