Chapter 7 Federal Statutes and Regulations That Impact Healthcare 129 Copyright Goodheart-Willcox Co., Inc. The Rehabilitation Act The Rehabilitation Act of 1973 prohibits discrimination based on dis- ability in programs run by federal agencies, programs that receive federal financial assistance, federal employment, and the employment practices of federal contractors. In 1998, Congress amended the Rehabilitation Act of 1973 so that it required federal agencies to make their electronic and information technology accessible to people with disabilities. The law applies to all federal agencies. For example, pictures on web pages now need to have text embedded in metadata (hidden background informa- tion) in a format that allows screen readers to describe the picture to visually impaired persons. The Emergency Medical Treatment and Active Labor Act In 1986, Congress enacted the Emergency Medical Treatment and Active Labor Act (EMTALA) to ensure public access to emergency services regardless of ability to pay. The law was intended to prevent the practice of patient dumping. The term patient dumping describes the transfer of patients, for financial reasons only, from private to public hospitals with- out consideration for their medical condition or stability for the transfer. The laws states that: “In the case of a hospital that has a hospital emergency depart- ment, if any individual comes to the emergency department and a request is made on the individual’s behalf for examination or treatment for a medical condition, the hospital must provide for an appropriate medical screening examination within the capa- bility of the hospital’s emergency department, including ancil- lary services routinely available to the emergency department, to determine whether or not an emergency medical condition exists.” Hospitals that are participating in Medicare and that offer emer- gency services are required to provide a medical screening examina- tion (MSE) when a request is made for examination of or treatment for an emergency medical condition (EMC) regardless of an individual’s ability to pay. This obligation applies only to Medicare-participating hospitals, which include most of the hospitals in the United States, but it does not apply only to Medicare patients. This obligation applies to any individual, even if he or she is not a United States citizen. EMTALA imposes the following three legal duties on hospitals: 1. Hospitals must perform an MSE on any person who comes to the hospital and requests care to determine whether an EMC exists (Figure 7.9). Rehabilitation Act law that prohibits discrimination based on disability in programs run by federal agencies, programs that receive federal financial assistance, federal employment, and the employment practices of federal contractors Emergency Medical Treatment and Active Labor Act (EMTALA) a law created to ensure public access to emergency services regardless of ability to pay