Can a Hospital Refuse Someone Who Has Had a Possible Stroke Because Their AHCCS Coverage Ran Out?

by wvs

Question by WTH (idea: Can a hospital refuse someone who has had a possible stroke because their AHCCS coverage ran out?
My ex wife had what to me was an obvious stroke.Her right arm was like jello she couldn’t walk and complained her chest hurt.When her sister took her to a local hospital(TMC in Tucson AZ) They refused to admit her because her AHCCCS card had expired . Can they really do that? If so what are her options?

Best answer:

Answer by Brian
While the stroke may be obvious to you if the ER physician gave her a full work up and found nothing wrong there really is no reason to admit her unless they’re gonna obs her for the night to cover their butt. A lot of times bells palsy or a TIA can go home that day with instructions to follow up with your personal physician for further testing or to come back in if things get worse. I highly doubt they refused to admit her cause her AHCCCS card expired. The reason why I’m so sure is 99/100 times an ER physician won’t even know your insurance until they go to admit you the reason why is cause it doesn’t matter what insurance a person has till that time. The only reason why it even matters at all is so you can admit the patient to the right hospitalist as certain hospitalist groups are contracted with certain insurance companies.

Answer by Grandmere
I am in California, and I know here that hospitals MUST treat a person in an emergency, regardless of their ability to pay. There are signs throughout the hospital to inform patients of this right so I checked and it is a federal law, therefore, it applies to ALL states.

The Right to Treatment

If individuals do not carry health insurance, they are still entitled to hospital emergency care, including labor and delivery care, regardless of their ability to pay. The federal Emergency Medical Treatment and Active Labor Act (EMTALA), 42 U.S.C. 1395, which is a separate section of the more comprehensive 1985 Consolidated Omnibus Reconciliation Act (COBRA), mandates minimum standards for emergency care by hospital emergency rooms. The law requires that all patients who present with an emergency medical condition must receive treatment to the extent that their emergency condition is medically “stabilized,” irrespective of their ability to pay for such treatment.

An emergency medical condition is defined under federal law as one that manifests itself by acute symptoms of sufficient severity (including severe pain, psychiatric disturbance, and/or symptoms of substance abuse) such that the absence of immediate medical attention could reasonably be expected to result in the following:

* Placing the health of the individual (or unborn child) in serious jeopardy
* The serious impairment of a bodily function
* The serious dysfunction of any bodily function or part
* The inadequate time to effect a safe transfer of a pregnant woman to another hospital before delivery, or, that the transfer may pose a threat to the health or safety of the woman or unborn child

The law goes on to define “stabilization” as meaning “that no material deterioration of the condition is likely within reasonable medical probability to result from or occur during the transfer of the patient from a facility” (or discharge).

However, once the emergency is over and a patient’s condition is stabilized, the patient can be discharged and refused further treatment by private hospitals and most public hospitals. If the individual seeks routine medical care or schedule a doctor’s appointment for non-emergency medical problems, doctors have a general right to refuse treatment if they have no insurance or any other means of paying for the provided care.

If she is experiencing life-threatening symptoms she should return to the hospital, and whoever escorts her should ask to speak to a supervisor if she is refused treatment. They need to let this person know that they are aware that by Federal law, the hospital is required to assess her situation and admit her if necessary, but cannot refuse to treat her because her insurance card has expired.

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