Covenant found in violation of federal law on emergency care
URBANA — Medicare payments at Presence Covenant Medical Center could be interrupted after July 30 because the hospital was found to be in violation of a federal law intended to guarantee access to emergency medical care regardless of the patient's ability to pay.
Medicare announced in a legal ad that ran in The News-Gazette last Saturday that the federal government won't make payments for inpatient hospitals services admitted to Presence Covenant on or after July 30.
Elizabeth Surgener, a spokeswoman for the Centers for Medicare and Medicaid Services, said Monday that the agency has already accepted a plan of correction from the hospital.
However, to be reinstated by the federal agency, Covenant will also have to demonstrate the corrections are in place in an unannounced survey that will be conducted by the Illinois Department of Public Health before July 30.
"That will determine the next step," Surgener said.
Presence Covenant failed to comply with part of the Emergency Medical Treatment and Active Labor Act, or EMTALA, according to CMS.
EMTALA is commonly known as the patient "anti-dumping" law because it was intended to stop hospitals from transferring uninsured and Medicaid patients to public hospitals.
The law requires hospitals that accept Medicare patients to provide emergency care for all patients coming to their emergency departments, regardless of their ability to pay a hospital bill.
Surgener said Presence Covenant was surveyed April 16 by the state Department of Public Health, based on an allegation of noncompliance with the law. CMS reviewed the finding and determined the hospital was in violation, she said.
Specifically, Covenent was found to be in violation, "based on a failure to accept an individual who required the hospital's specialized capabilities, and for failing to have and enforce policies that ensure compliance with related requirements to EMTALA," she said in an email.
A hospital violating these provisions is subject to termination of its Medicare provider agreement.
A termination can be lifted if a hospital can show a violation didn't occur, or a plan of correction submitted by the hospital is approved and the correction plan has been demonstrated to be in effect in an unannounced survey, Surgener said.
Presence Covenant Medical Center submitted a plan of correction in response to a routine state Department of Public Health survey, hospital spokeswoman Crystal Senesac said.
"Unfortunately, the notice to the public is part of an automated response from the CMS system, which was produced between the time Presence Covenant submitted the POC (plan of correction) and CMS accepted it," she said in an emailed response to an inquiry from The News-Gazette.
Senesac also said the state health department will resurvey Presence Covenant to ensure that corrections have been made and that Presence Covenant's participation in the Medicare and Medicaid programs won't change.
"Presence Covenant's mission calls the ministry to care for the needs of all in the community, particularly those most vulnerable populations such as those serviced by the Medicare and Medicaid programs," she said. "We continue business as usual, providing excellent care for our community, and we look forward to a resurvey."