Medicare Compliance & Reimbursement

A ten-year-old patient anti-dumping case that worked its way all the way up to the U.S. Supreme Court and back may finally be coming to an end - with the hospital in the case scoring a victory. The 6th U.S. Circuit Court of Appeals April 9 shot down the plaintiff's appeal of a jury verdict in Roberts v. Galen of Virginia Inc. (No. 93-00544). The case centered on care provided to Wanda Johnson, who was rushed to a Galen of Virginia hospital after being hit by a truck. Two months later, she was transferred to a skilled nursing facility, after which her health deteriorated. Johnson's guardian then sued Galen under the Emergency Medical Treatment and Active Labor Act. The case ended up producing an important Supreme Court ruling - establishing that plaintiffs don't have to prove that a hospital has an "improper motive" for transferring a patient to maintain an EMTALA claim - before finally being tried. The hospital won, both in the trial court and, thanks to the 6th Circuit's ruling, on appeal. To see the 6th Circuit's ruling, go to http://pacer.ca6.uscourts.gov/cgi-bin/getopn.pl?OPINION=03a0107p.06. Lesson Learned: Hospitals can face protracted EMTALA litigation even when there's no ill intent in transferring a patient.