What is important to note regarding malingering and EMTALA?

• A. Suspected malingering is exempt from EMTALA.
• B. Suspected malingering is NOT exempt from EMTALA: if patient presents with suspected malingering -> still provide a documented MSE to prove no emergency exists.
• C. MSE is not necessary if malingering suspected.
• D. Malingering automatically requires discharge.

Answer: (B)

Under EMTALA, everyone who presents to an emergency department must receive a medical screening examination to determine whether an emergency medical condition exists, regardless of suspicions that the patient might be malingering. Even when malingering is suspected, the obligation is not waived. The correct approach is to perform a documented medical screening examination to assess whether an emergency exists. If the screening shows no emergency, you document that finding and may discharge or provide appropriate non-emergency care with follow-up instructions. If there is an emergency, you must stabilize and treat the patient.

This is why statements that malingering exempts someone from EMTALA or that the MSE isn’t needed are incorrect. It’s also not correct to discharge solely on the basis of suspected malingering without first performing and documenting the MSE and evaluating for an actual emergency.