Panel defers to hospitals on false-labor cases.(Practice Trends)

WASHINGTON -- Local laws and practice patterns should dictate which health care providers can certify false labor cases, according to a preliminary recommendation from the Emergency Medical Treatment and Labor Act Technical Advisory Group.

Currently, the EMTALA, which is now law, recognizes only physicians as qualified to certify false-labor cases. Agreeing with the recommendations of one of its subcommittees, the technical advisory group determined at its recent meeting that this requirement was "inconsistent with the scope of practice for nurse-midwives and other practitioners under state laws," and should therefore be eliminated.

Instead, hospital policies and procedures should dictate which personnel are capable of making such an assessment, said the panel, which advises the Department of Health and Human Services and the administrator of the Centers for Medicare and Medicaid Services (CMS) on issues related to EMTALA.

The changes proposed by the technical advisory group's subcommittee "would allow a hospital to take into account state law, federal law, local practice patterns, and scope of practice and make a decision that works for that hospital and its patients," Charlotte Yeh, M.D., a member of the technical advisory group, an emergency physician, and the CMS regional administrator for Region I in Boston, told this newspaper.

Deanne Williams, a certified nurse-midwife and executive director of the American College of Nurse-Midwives, called the action "a very important step towards eliminating a significant barrier to care that was mistakenly created by the EMTALA regulations."

Laws in every state permit nurse-mid-wives to determine if a woman is in false labor, she said. "We are very hopeful that this problem will be fixed quickly. As more hospitals create labor triage units, they will need teams of ...