Medicare-certified hospitals and critical access hospitals with emergency departments must follow federal law and Centers for Medicare and Medicaid Services (CMS) regulations and interpretative guidelines for the Emergency Medical Treatment and Labor Act (EMTALA). This three-part series will focus on EMTALA concepts, adequacy of medical screening and on-call physician issues. Fines have more than doubled since 2015 when CMS implemented the inflationary adjustment retroactive to the implementation of the EMTALA regulations.