G O V E R N M E N T R E L AT I O N S
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Office of Civil Rights Denies ADA Request for Extension on Implementation
of Section 1557 of the Affordable Care Act
On May 18, the U.S. Department of
Health and Human Services published a
final rule under Section 1557 of the
Affordable Care Act to protect individuals
from discrimination in health care on the
basis of race, color, national origin, age,
disability and sex, including discrimination
based on pregnancy, gender identity and
sex stereotyping. Section 1557 is enforced
by the Office for Civil Rights (OCR),
the federal agency that enforces HIPAA.
Sec. 1557 prohibits entities that receive
federal financial assistance from
discriminating on the basis of race, color,
national origin, age, disability and sex. In
health care, the final rule applies to
recipients of certain funding from HHS,
such as funding under Medicaid, CHIP and
Medicare Advantage plans. Compliance
requirements include requiring covered
entities to “provide meaningful access
to individuals with limited English
proficiency” as well as providing qualified
interpreters and translators.
In July, the American Dental Association
requested an extension of the
implementation deadlines, noting that
while the ADA strongly supports
nondiscrimination, it was concerned that
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the final rule “risks further limiting patient
access to care.” ADA also urged OCR
to take into account the financial and
other burdens that the rule will impose
on small businesses.
The OCR said Aug. 15 that it will not delay
enforcement of the final rule issued under
Section 1557 of the Affordable Care Act.
In OCR’s response, Director Jocelyn
Samuels told ADA President Carol Gomez
Summerhays and Executive Director
Kathleen T. O’Loughlin that because the
effective date (July 18) was “set by
operation of the final rule” OCR is not able
to make exceptions. Ms. Samuels also
said OCR had devoted “substantial
resources” to the development of the
estimate of the burdens and benefits posed
by the regulation.
While Sec. 1557 does not apply to Medicare
Part B, OCR did clarify that the final rule
does apply to any provider who receives
reimbursement for Medicare Part C,
Medicare Advantage, regardless of whether
the plan reimburses the dentist or the
patient.
For dental practices that receive certain
federal financial assistance from HHS,
such as under Medicaid or CHIP, the Sec.
1557 final rule will require that they post
notices of nondiscrimination as well as
taglines in the top 15 non-English languages
spoken in the state indicating that free
language assistance services are available.
The compliance date for the notices is
Oct. 16. The rest of the rule went into
effect July 18.
The notices must be posted in the dental
office, on the website and in any significant
publications and communications. For
smaller items, such as postcards and
tri-fold brochures, the practice may use a
shorter nondiscrimination statement and
taglines in the state’s top two non-English
languages spoken.
To minimize the administrative burden
for member dentists who are covered
entities, the ADA has prepared resources
to aid in compliance with the rule,
including an FAQ and checklist. Visit
ADA.org/1557. There are also sample
materials available on the OCR’s website
at www.hhs.gov/ocr.
(Editor’s Note: Most of the information in
this article reprinted from ADA News)