Referrals

For non-emergency care, referrals to alternate facilities must be required if a hospital, clinic or health system is refusing to treat  the patient.

Acceptable referral practices must include, at minimum, reviewing all the patient’s health care treatment options with him or her; explaining which of those options are available at the hospital and which are not; providing the patient with names, addresses and phone numbers of alternative providers; and ensuring that the patient is able to travel to at least one of these alternative providers and has insurance coverage (including Medicaid) which will be accepted there.

Additional assistance must be given when a patient is at risk of not receiving care at an alternative provider for reasons such as transportation problems, lack of financial resources, physical or emotional instability, youthful status or diminished capacity.  In such cases, the hospital must take active steps to ensure that the patient is able to receive treatment at an alternate provider.

Such referral procedures should be incorporated into hospital policies transmitted in employee training sessions and enforced through internal review and quality assurance processes. Further, referrals to alternate facilities when treatment is being refused should be required and enforced by hospital licensing and accrediting bodies and should become conditions of participation in the Medicare and Medicaid programs.