AANS - Emergency Care and Stroke

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Emergency Care and Stroke

Legislative Activities

Emergency Care & Stroke

AANS/CNS Support CMS’ Decision Not to Expand EMTALA Rules to Inpatients
Congress Investigates the Impact of Concussions on High School Athletes. Neurosurgeons Weigh-In on this Important Topic
AANS and CNS Comment on Proposed Changes to EMTALA (PDF 78KB)
2007:Congress Passes Trauma Care Legislation - Please Thank Your Senators and Representatives and Urge them to Support Full Funding
2006:House of Representatives Passes Stroke Legislation - Please Thank Your Representatives and Urge Your Senators to Pass this Legislation!
Neurosurgeons May Be Eligible for Federal Funds for Emergency Care Costs
March 2005: AANS/CNS Submit Comments to EMTALA Technical Advisory Group. Click here for a copy of the comments (PDF 250KB)
2005: AANS/CNS Submit Comments to EMTALA Technical Advisory Group. Click here for a copy of the comments (PDF 250KB)
July 9, 2002: Comments to HHS regarding proposed rule relating to the "Responsibilities of Medicare Participating Hospitals in Emergency Cases" under the Emergency Medical Treatment and Active Labor Act (EMTALA)
As a result of extreme pressure by neurosurgery, on June 13th, the Centers for Medicare and Medicaid Services (CMS) issued a memorandum to its state and regional enforcement offices clarifying the EMTALA rules (the State Operation Manual - SOM) related to simultaneous call. The memo states "After lengthy discussions with the medical community, and understanding the impact of this policy, CMS is revising its policy to allow on-call physicians to provide coverage simultaneously at several hospitals to maximize patient access to care. As required in the SOM, hospitals must have policies and procedures to follow when an on-call physician is simultaneously on-call at another hospital and are not available to respond. Hospital policies may include, but are not limited to procedures for back-up on-call physicians, or the implementation of an appropriate EMTALA transfer..."
On the same day, CMS also published additional guidance for on-call physicians in the form of a question and answer document. This publication also addresses the issues of 24/7/365 on-call coverage and rules related to scheduling and performing elective surgery while on-call.
June 13, 2002: Clarification from CMS regarding hospital responsibilities concerning on-call physicians (PDF 23KB)
June 13, 2002: Question & Answer Document(PDF 16KB)
The Centers for Medicare and Medicaid Services recently pronounced that serving on-call to more than one hospital simultaneously and performing elective surgery while on-call to the emergency department may violate EMTALA. The AANS and CNS are therefore urging all neurosurgeons to write CMS and object to this policy. On this page you will find a variety of information related to this topic.
May 31, 2002: AANS/CNS Action Alert(PDF 31KB)
Sample Comment Letter (PDF 18KB)
May 30, 2002: AANS/CNS Comment Letter to CMS (PDF 68KB)
Executive Summary of AANS/CNS Comment Letter to CMS (PDF 42KB)
May 9, 2002: EMTALA Federal Register Notice
Go to http://www.access.gpo.gov/su_docs/fedreg/a020509c.html and scroll down to the Centers for Medicare and Medicaid Services. The EMTALA regulations are included in the "Hospital Inpatient Prospective Payment Systems and 2003 FY Rates." Because the document is so large it is divided into several files. The EMTALA regulations are on p.31469-31479. The on-call provisions begin on p. 31478.
May 8, 2002: (PDF 16KB)
April 15, 2002: AANS/CNS Letter to HHS Secretary Tommy G. Thompson (PDF 60KB)
EMTALA Quick Reference Guide for On-Call Physicians. American Medical Association
http://www.ama-assn.org/ama/pub/category/2650.html
For More Information: If you have any questions related to this or other health policy issues, please contact Katie O. Orrico, Director, AANS/CNS Washington Office at 202-628-2072 or via e-mail at korrico@neurosurgery.org

Stroke

2004

2003

January 24, 2003 -- Advancing the STOP Stroke Act in the 108th Congress Core Principles (PDF 21KB) from the STOP Stroke Coalition

2002

November 5, 2002: Position Statement on the International Subarachnoid Aneurysm Trial and Talking Points
October 31, 2002: Serving the Best Interest of Stroke Patients: Advancing Separate Systems for Stroke and Trauma -- Consensus Statement of National Organizations Dedicated to Improving Stroke Care
August 12, 2002: Comments from AANS/CNS Section on Cerebrovascular Surgery to NINDS regarding the Report of the Stroke Progress Review Group (PDF 4KB)

2001

Summary information on The Stroke Treatment and Ongoing Prevention Act of 2001 (PDF 10KB) and the Senate Bill (PDF 165KB)