CMS SOM App. W, Tag C-2406

(1) In the case of a hospital that has an emergency department, if an individual

(whether or not eligible for Medicare benefits and regardless of ability to pay) "comes

to the emergency department", as defined in paragraph (b) of this section, the hospital

must (i) provide an appropriate medical screening examination within the capability of

the hospital's emergency department, including ancillary services routinely available to

the emergency department, to determine whether or not an emergency medical

condition exists. The examination must be conducted by an individual(s) who is

determined qualified by hospital bylaws or rules and regulations and who meets the

requirements of §482.55 of this chapter concerning emergency services personnel and

direction; and

(b) If an emergency medical condition is determined to exist, provide any necessary

stabilizing treatment, as defined in paragraph (d) of this section, or an appropriate

transfer as defined in paragraph (e) of this section. If the hospital admits the

individual as an inpatient for further treatment, the hospital's obligation under this

section ends, as specified in paragraph (d)(2) of this section.

(2) Nonapplicability of provisions of this section.

Sanctions under this section for inappropriate transfer during a national emergency or

for the direction or relocation of an individual to receive medical screening at an

alternate location do not apply to a hospital with a dedicated emergency department

located in an emergency area, as specified in section 1135(g)(1) of the Act. A waiver of

these sanctions is limited to a 72-hour period beginning upon the implementation of a

hospital disaster protocol, except that, if a public health emergency involves a

pandemic infectious disease (such as pandemic influenza), the waiver will continue in

effect until the termination of the applicable declaration of a public health emergency,

as provided for by section 1135(e)(1)(B) of the Act.

(c) Use of Dedicated Emergency Department for Nonemergency Services

If an individual comes to a hospital's dedicated emergency department and a request is

made on his or her behalf for examination or treatment for a medical condition, but

the nature of the request makes it clear that the medical condition is not of an

emergency nature, the hospital is required only to perform such screening as would be

appropriate for any individual presenting in that manner, to determine that the

individual does not have an emergency medical condition.