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> Medical providers aren't supposed to deny procedures based on insurance coverage. This is false. There's EMTALA, which requires that emergency services will
by mlyle 2y ago
> Medical providers aren't supposed to deny procedures based on insurance coverage.
This is false. There's EMTALA, which requires that emergency services will be provided until a patient can be transferred. But doctors absolutely refuse to provide services based on ability to pay all the time.
- legitster 2y agoGood point. But as the original story made the rounds on social media, it got exaggerated to make it sound like this was a life-threatening surgery. Knowing that it was a routine call and it was a plastic surgery procedure definitely deflates the scandal of the whole thing.
- ceejayoz 2y agoRemoving a brain tumor is "life-threatening surgery", but it won't be subject to EMTALA requirements.
- nradov 2y agoWell that would depend on the facts of a particular case. If a patient presents at the ER with a brain tumor which is causing severe symptoms such as unstable vital signs then under EMTALA the hospital might be legally required to remove the tumor regardless of the patient's ability to pay.
- ceejayoz 2y agoNo; the tumor itself would be non-emergent. The symptoms it causes - pain, for example - would be treated, then the patient would be discharged with a suggestion of a follow up with oncology.
- nradov 2y agoAre you certain about that? I think it would really depend on the severity of symptoms. Cases like Munoz v. Watsonville Community Hospital et al indicate that courts have interpreted the legal requirement to stabilize the patient rather more broadly. Just discharging the patient with painkillers and a referral isn't necessarily sufficient to avoid liability.
- ceejayoz 2y agoYes; that case involves a clearly emergent post-surgical complication. https://casetext.com/case/diaz-v-division-of-soc-servs-1 https://casetext.com/case/diaz-v-division-of-soc-servs-1, as an example, involved a case where chemo was warranted for emergency treatment, but not on an ongoing basis. The court found they could treat enough to stabilize, then discharge, even if that guaranteed an emergent return later on.
- theossuary 2y agoI always find it kinda funny in a morbid way when somebody finds out for the first time that the US healthcare system lets people die all the time because they have the wrong insurance or not enough money. Hell they let people die all the time who have the correct insurance and enough money, health insurers just deny and delay long enough to save some money. There's a good reason Luigi killed the CEO of United Healthcare.