Massa, J.
Betty Miller sued numerous health-care providers for negligently treating her mentally ill grandson. More than two years after the treatment, she sought to amend her complaint under Indiana Trial Rule 15(C) to allege a violation of 42 U.S.C. § 1395dd, the Emergency Medical Treatment and Labor Act (EMTALA), which has a two-year statute of limitations. The trial court denied her request, and an appellate panel affirmed. Both concluded the statute of limitations preempted an amendment under our trial rules. Because we find no preemption, we reverse and remand.
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Congress enacted EMTALA to prevent hospitals from “dumping” indigent patients. Brooks v. Md. Gen. Hosp., Inc., 996 F.2d 708, 710 (4th Cir. 1993) (internal quotation marks omitted). To that end, EMTALA requires hospital emergency departments to (1) screen individuals for “emergency medical condition[s]” and (2) stabilize any such conditions or transfer the individuals as permitted by the statute. 42 U.S.C. § 1395dd(a)–(c). An individual personally harmed by a hospital’s violation of an EMTALA “requirement” may sue that hospital, 42 U.S.C. § 1395dd(d)(2)(A), in state or federal court, HCA Health Servs. of Ind., Inc. v. Gregory, 596 N.E.2d 974, 977 (Ind. Ct. App. 1992), trans. denied. However, the action must be brought no “more than two years after the date of the violation.” 42 U.S.C. § 1395dd(d)(2)(C).
Federal law preempts state law when the two are at odds, U.S. Const. art. VI., and this preemption can be express or implied, Norfolk S. Ry. Co., 107 N.E.3d at 471. Express preemption occurs when Congress explicitly defines a statute’s “preemptive effect.” Basileh v. Alghusain, 912 N.E.2d 814, 818 (Ind. 2009). EMTALA contains an express preemption clause: “The provisions of this section do not preempt any State or local law requirement, except to the extent that the requirement directly conflicts with a requirement of this section.” 42 U.S.C. § 1395dd(f). In Williams, 142 N.E.3d at 476, the Court of Appeals relied on this preemption clause to hold that Trial Rule 15(C) was preempted, because its application “would directly conflict with” EMTALA’s two-year statute of limitations. We now conclude there is no direct conflict and disapprove Williams’ contrary holding.
While an express preemption clause “supports a reasonable inference” that Congress did not intend preemption beyond that clause, it does not “entirely foreclose[]” implied preemption. Freightliner Corp. v. Myrick, 514 U.S. 280, 288–89 (1995); see also Hillman v. Maretta, 569 U.S. 483, 498 (2013). Implied preemption occurs through conflict and field preemption. Norfolk S. Ry. Co., 107 N.E.3d at 471. Conflict preemption arises when federal and state law directly conflict, making it impossible to comply with both, or when state law is “an obstacle to the accomplishment and execution of the full purposes and objectives of Congress.” Basileh, 912 N.E.2d at 818. Field preemption arises when comprehensive federal legislation occupies an entire field of regulation, leaving no room for state law. Id. Here, we conclude neither type of implied preemption exists.
I. EMTALA’s statute of limitations does not expressly preempt Miller’s proposed amendment under Trial Rule 15(C).
EMTALA’s preemption clause is noticeably narrow. It disclaims preemption except when there is a direct conflict between a “State or local law requirement” and an EMTALA “requirement.” 42 U.S.C. § 1395dd(f)…..
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II. There is no implied preemption that would prevent Miller’s proposed amendment under Trial Rule 15(C).
The absence of express preemption does not end our analysis. See Myrick, 514 U.S. at 288–89. We must still consider the two strands of implied preemption: conflict and field. And we conclude neither prohibits Miller’s proposed amendment.
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Conclusion
Because we find EMTALA’s statute of limitations does not preempt an amendment under Trial Rule 15(C), we reverse the trial court. In denying Miller’s motion, the trial court focused only on preemption. It must now consider whether the EMTALA claim arose out of the same conduct set forth or attempted to be set forth in the original complaint, along with other relevant factors. See Palacios v. Kline, 566 N.E.2d 573, 575 (Ind. Ct. App. 1991). Accordingly, we remand for reconsideration of Miller’s motion in light of our opinion.
Rush, C.J., and David, Slaughter, and Goff, JJ., concur.