After an accident an injured person may be rushed to the nearest hospital without much consideration for questions like insurance coverage or ability to pay for care. Just an ambulance ride can be very expensive, not to mention the costs associated with treatment in an emergency room. Once at the hospital, patients or their loved ones may have questions about how much care a hospital is obligated to provide, regardless of ability to pay.
One of the challenges of answering this question comes from the variety of medical facilities in Nevada. Medical facilities run the gamut from local clinics with limited physician staffing to full-scale, 24-hour hospitals. Facilities are licensed and regulated according to the type of services they provide. This piece focuses on hospitals and the statutory rules that govern them.
Nevada state law also requires provision of emergency care
Under NRS 439B.410 a Nevada hospital is required to provide emergency services to patients regardless of their ability to pay. Hospitals are also prohibited from transferring patients to other facilities as a consequence of the patient’s insurance status. Emergency care includes:
- Screening the patient to identify any emergency medical condition, which is defined as the presence of acute symptoms that could result in serious jeopardy to the patient’s health, serious impairment of the patient’s bodily functions, or serious dysfunction of an organ or body part.
- Provision of care, including surgery, to relieve or eliminate the emergency medical condition.
Nevada law requires that patients who are admitted on an emergency basis are provided with an appropriate place within the hospital (a bed, chair, etc.) within 30 minutes of arrival at the hospital. NRS 450B.790. Note, however, that hospitals can’t be sued for breaching this rule.
Federal law places specific requirements on hospitals that accept Medicare
Federal law requires any hospital that accepts Medicare to provide emergency services to patients regardless of whether the patient is eligible for Medicare or otherwise has the ability to pay for services. 42 CFR § 489.24. The obligation to provide basic emergency services arises whenever a person presents themselves on hospital grounds and requests care or appears to be in need of medical care. This includes arriving by ambulance. Medicare hospitals must:
- Provide initial screening exams to evaluate the patient’s condition.
- If an emergency medical condition exists, provide stabilizing treatment and, if determined to be necessary, admit the person as an in-patient or transfer the patient to a hospital that can provide appropriate treatment.
These services must be provided without delaying to first find out if the patient has insurance or the ability to pay, but hospitals are allowed to ask such questions in the course of registering the patient.
Hospitals can still charge for emergency services
Even though a hospital is required to provide emergency services regardless of a patient’s apparent ability to pay, the hospital can and will bill for the services it provides. This can come as a shock to patients who seek care and later get huge bills in the mail for ambulance rides, surgeries, and so on. Bills can be especially high for patients who are not insured, or who have been treated by a facility that is not within their insurer’s network.
People faced with significant bills can often negotiate them down. In general, hospitals would rather get paid something rather than hand over a large bill to a collection agency with little hope of seeing a dime. If the emergency that led to the hospital visit arose as a consequence of an accident, the hospital may accept a lien against the anticipated settlement with the person responsible for the injury. A personal injury lawyer can help sort out these options.
For over 45 years the law firm of Greenman Goldberg Raby Martinez has represented Las Vegas clients in personal injury cases. If you have questions about how to handle the aftermath of an emergency room visit, we may be able to help. Call us today for a free, confidential attorney consultation. We can be reached at 702-388-4476 or send us a request through our site.