Being Denied Emergency Medical Care in New York
I was denied emergency medical care — here's what New York law says and what to do next.
Statute: N.Y. Fin. Servs. Law § 603 et seq. (Emergency Medical Services and Surprise Bills Law — specified state law)
Deadline: 120 days
Penalty: New York has a specified state law under the NSA. New York pioneered surprise billing protections in 2015. State-regulated plans use New York's IDR 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 New York differs from federal law
New York provides significant additional emergency care protections beyond federal EMTALA:
- NY Public Health Law § 2805-b: Requires all general hospitals to maintain emergency services and treat all patients who present with emergency conditions, regardless of ability to pay. Hospitals cannot delay treatment to verify insurance or payment.
- Emergency room "prudent layperson" standard: NY Insurance Law § 3216(i)(10) requires insurance plans to cover emergency services based on the presenting symptoms, not the final diagnosis. If a reasonable person would have believed they needed emergency care, the insurer must cover it.
- NY Medicaid emergency coverage: New York provides Emergency Medicaid to individuals who meet financial eligibility requirements but are ineligible for full Medicaid due to immigration status. Coverage includes emergency room visits, emergency labor and delivery, and emergency surgery.
- NY's psychiatric emergency protections: NY Mental Hygiene Law provides specific protections for psychiatric emergencies, including requirements for psychiatric screening in emergency departments and limits on involuntary psychiatric holds.
Additional steps in New York
File a complaint with the NY State Department of Health at health.ny.gov or call (800) 804-5447. For insurance disputes about emergency coverage, contact the NY Department of Financial Services at dfs.ny.gov or call (800) 342-3736. Contact the Community Health Advocates at (888) 614-5400 for free help.
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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