GET READY! SOME OF THE ACA’S NEWLY IMPLEMENTED REGULATIONS MAY COME AS A SURPRISE!

Another section, Section 1557, of the Affordable Care Act (aka: ACA or Obamacare which has been in effect since March 2010) was implemented on July 18, 2016.  Section 1557 prohibits health care entities which accept payment from federal financial assistance programs including Medicaid, CHIP, and, yet to be determined, Medicare Part C (Medicare Advantage), from discriminating based on race, color, nationality, age, disability, or sex.  The addition of the gender category makes Section 1557 of the ACA the first federal civil rights law affecting health care facilities to include reference to sex; however, these non-discriminatory specifics are not much of a surprise.


Section 1557 specifically protects people with disabilities by requiring “newly constructed or altered facilities accessible to individuals with disabilities” and requiring provision of “appropriate auxiliary aids and services” for those with disabilities.  The definition of “appropriate aids and services” is not clear.  The requirement for accessible facilities has been in effect since passage of the Americans with Disabilities Act (ADA), so again, not much of a surprise.


Further, the Office for Civil Rights (OCR) that operates under the U.S. Department of Health and Human Services, has ruled that “covered entities” (in our case, dental offices which accept payment from federal financial assistance programs)  must provide qualified interpreters and translators for patients with “limited English proficiency.”  Translated into practical terms, this would seem to mean that every time you schedule a non-English speaking patient, you must pay a translator to be in your office to serve that patient.


Further, according to the OCR, dental offices must post a notice of non-discrimination, including explanatory tag lines, written in the top 15 non-English languages spoken in that state.  These postings must include notice of the availability of free language assistance services, and they must appear on the practice’s website and other major forms of publications and communications from the office.


Minor office communication tools such as Recare post cards, business cards, the practice brochure, and such can include a shorter non-discrimination statement with explanatory tag lines written ONLY in the top two non-English languages spoken in that state.  Surprise?


Further, according to the OCR, covered dental practices with 15 or more employees (total employees at all locations of a practice) must implement a formal grievance procedure with one staff member responsible for record keeping and processing of grievances concerning any of the aforementioned requirements.  Surprise?


Further, according to the OCR, the deadline for implementation of these requirements is October 16, 2016.  Now that may be a surprise!


For help in implementing these regulations, go to the American Dental Association’s website at  www.Success.ADA.org/1557resources to order resources for implementation, including  Frequently Asked Questions and a Checklist of steps to implementation.  Or, if you are very brave and patient, you can do as I did in researching information for this article:  (1) Go to www.hhs.gov.  Click on Section 1557 of the Patient Protection and Affordable Care Act.  (2) From there, you may choose to access the full version of this Section 1557 of the ACA in the Federal Register (I don’t recommend trying to read and absorb the full version unless you have unlimited time and a law degree in addition to your dental degree!) or you may choose other portals to read portions of Section 1557.