Page:United States Statutes at Large Volume 100 Part 1.djvu/201

 PUBLIC LAW 99-272—APR. 7, 1986

100 STAT. 165

"(3) REFUSAL TO CONSENT TO TRANSFER.—A hospital is deemed to meet the requirement of paragraph (1) with respect to an individual if the hospital offers to transfer the individual to another medical facility in accordance with subsection (c) but the individual (or a legally responsible person acting on the individual's behalf) refuses to consent to the transfer. '(c) RESTRICTING TRANSFERS UNTIL PATIENT STABILIZED.—

"(1) RULE.—If a patient at a hospital has an emergency medical condition which has not been stabilized (within the meaning of subsection (e)(4)(B)) or is in active labor, the hospital may not transfer the patient unless— "(A)(i) the patient (or a legally responsible person acting on the patient's behalf) requests that the transfer be effected, or "(ii) a physician (within the meaning of section 1861(r)(l)), 42 USC I395x. or other qualified medical personnel when a physician is not readily available in the emergency department, has signed a certification that, based upon the reasonable risks and benefits to the patient, and based upon the information available at the time, the medical benefits reasonably expected from the provision of appropriate medical treatment at another medical facility outweigh the increased risks to the individual's medical condition from effecting the transfer; and "(B) the transfer is an appropriate transfer (within the meaning of paragraph (2)) to that facility. "(2) APPROPRIATE TRANSFER.—An appropriate transfer to a

medical facility is a transfer— "(A) in which the receiving facility— "(i) has available space and qualified personnel for the treatment of the patient, and "(ii) has agreed to accept transfer of the patient and to provide appropriate medical treatment; "(B) in which the transferring hospital provides the receiving facility with appropriate medical records (or copies thereof) of the examination and treatment effected at the transferring hospital; "(C) in which the transfer is effected through qualified personnel and transportation equipment, as required including the use of necessary and medically appropriate life support measures during the transfer; and "(D) which meets such other requirements as the Secretary may find necessary in the interest of the health and safety of patients transferred. '(d) ENFORCEMENT.— "(1) As REQUIREMENT OF MEDICARE PROVIDER AGREEMENT.—If a

hospital knowingly and willfully, or negligently, fails to meet the requirements of this section, such hospital is subject to— "(A) termination of its provider agreement under this title in accordance with section 1866(b), or 42 USC I395cc. "(B) at the option of the Secretary, suspension of such agreement for such period of time as the Secretary determines to be appropriate, upon reasonable notice to the hospital and to the public. "(2) CIVIL MONETARY PENALTIES.—In addition to the other grounds for imposition of a civil money penalty under section 1128A(a), a participating hospital that knowingly violates a 42 USC 1320a-7a.

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