Medical Transportation Research
About This Resource
When you create a Medi Transport Card, you're documenting which medical facilities you prefer — and which you'd like to avoid — in an emergency. Understanding the legal landscape around medical transport can help you have informed conversations with your healthcare providers, family members, and local EMS agencies about your preferences.
This page compiles the primary Emergency Medical Services (EMS) statutes for all 50 states and Washington D.C., along with notes on relevant patient destination provisions where they exist. Because most destination preference rules are handled at the local protocol level rather than in state statute, we also encourage you to contact your regional EMS agency directly.
Federal Baseline
Emergency Medical Treatment and Active Labor Act (EMTALA)
EMTALA is the federal floor for emergency medical care. It requires any Medicare-participating hospital with an emergency department to provide a medical screening examination and stabilizing treatment to any person who arrives seeking emergency care, regardless of their ability to pay or insurance status.
Relevance to transport: EMTALA restricts hospital-owned and -operated ambulances from automatically diverting patients to the owning hospital when community-wide EMS protocols direct transport to the closest appropriate facility. It does not generally grant patients a statutory right to choose their destination hospital in independent (non-hospital-owned) EMS systems — those rules are governed by state law and local protocol.
Enforced by: Centers for Medicare & Medicaid Services (CMS)
EMS Personnel Licensure Interstate Compact (REPLICA)
REPLICA allows licensed EMS professionals to practice across state lines without obtaining a separate license in each state. As of 2025, more than 40 states have enacted REPLICA legislation. This affects which EMS personnel may legally transport you, particularly near state borders.
Relevant when: You live near a state border, travel frequently, or receive transport that crosses state lines.
More information: emscompact.gov — verify current member states through the official compact website.
State-by-State EMS Statute Reference
Citations are provided as research starting points. Verify all statutes through your state's official legislative website. Most patient destination preference rules are established at the local protocol level, not in state statute.
| State | Primary EMS Statute | Act / Common Name | Regulatory Agency | Sources |
|---|
Key Notes for Patients
Most destination preference rules live in local protocols, not state law
In most states, the right to request a specific hospital is established through regional EMS protocols, medical director guidelines, and hospital diversion policies — not in the primary EMS statute. Contact your county or regional EMS agency to learn the specific rules in your area.
Conscious and competent patients generally have more latitude
In emergency situations where a patient is conscious, alert, and able to make decisions, EMS crews in many jurisdictions will attempt to honor destination preferences when medically appropriate and logistically feasible. Documenting your preferences in advance — as with a Medi Transport Card — gives you a clear, portable record to share with crew members.
Medical necessity takes precedence
In time-critical emergencies such as stroke, STEMI (heart attack), major trauma, or cardiac arrest, EMS crews are typically required by protocol to transport patients to the nearest appropriate specialty center regardless of preference. A preference card is most effective for non-life-threatening transports or situations where multiple hospitals can appropriately treat the condition.
State law changes regularly
EMS statutes are amended by state legislatures on an ongoing basis. Citation numbers, chapter organization, and agency names can change. Always verify through the official legislative website for your state before relying on any specific citation.
Further Research Resources
The following organizations maintain authoritative, up-to-date information on EMS law and regulation. We are not affiliated with any of these organizations.
Federal EMS policy, national guidelines, and links to all state EMS offices.
Interstate EMS licensure compact — member states and enacted legislation.
EMS legislation database and state health law summaries.
Official CMS interpretive guidelines for the federal EMTALA statute.
Includes a directory of state EMS offices with contact information.
National Association of EMS Physicians — clinical and policy resources.