Civil rights rule compliance required by Oct. 16

CDA has developed California-specific resources to assist dentists in meeting the Oct. 16 deadline for compliance with the U.S. Department of Health and Human Services' Office for Civil Rights' final rule concerning Section 1557 of the Affordable Care Act.

Section 1557, in effect since 2010, is the ACA's nondiscrimination provision, prohibiting discrimination on the basis of race, color, national origin, sex, age or disability in certain health programs and activities. The final OCR rule, issued in May, aims to educate consumers about their rights and help covered entities understand their obligations under Section 1557. (The OCR is actively investigating complaints of discrimination under the provision.)

Dentists participating as providers in the Denti-Cal and CHIP (formerly known as Healthy Families) programs and those provider entities who have received Meaningful Use funding from HHS are required to comply with the new rule.

Dentists must comply with the following elements of the rule by Oct. 16:

  • Post a Notice of Nondiscrimination in English in dental practices, on websites and in significant publications or communications.
  • Post taglines in the top 15 non-English languages spoken in California offering free language assistance. Post them in dental practices, on websites and in significant publications or communications.
  • For offices with 15 or more employees, post information regarding the dental practice's grievance procedure.

The new CDA resource, "Nondiscrimination Requirements Under the Affordable Care Act (Section 1557)," will help dentists comply with the OCR rule. The resource provides: a detailed background on the ACA provision and new OCR rule; checklist, instructions and recommended practices for dental practices to follow to meet the compliance requirements under the July 18 deadline (see the related story in the August issue of the CDA Update, page 10) and the forthcoming Oct. 16 deadline; sample grievance procedure and notice of nondiscrimination forms; questions and answers; and a list of additional resources.

Meanwhile, the ADA has submitted a letter to the director of the OCR requesting an extension of the compliance deadline to help dentists who have "limited staffs and resources" comply with the final rule.

"The ADA respectfully requests a delay in the enforcement date until there is sufficient time to allow for our members to meet the requirements," the letter states. The ADA has also asked that the "most burdensome regulations" apply only to dental practices with at least 25 staff. Further ADA efforts include mobilizing members to urge their congressional representatives to take action. Dentists who wish to take part in this grassroots effort can sign on at the ADA's legislation action center.

CDA will inform its members of any granted deadline extensions or other developments on cda.org and in upcoming issues of the CDA Update.

Related Items

Dental practices that receive payments from certain types of government programs, such as Denti-Cal, Healthy Families, Medicare or electronic health records incentive (“meaningful use”), must comply with rules adopted under the Affordable Care Act Section 1557 that protect individuals from discrimination in health care based on race, color, national origin, age, disability, and sex, including discrimination based on pregnancy, gender identity, and sex stereotyping.  The Office of Civil Rights within the U.S. Department of Health and Human Services enforces the rules. This resource includes an overview of the requirements, a sample interpreter/translator agreement, statement of nondiscrimination, tag lines in 15 non-English languages, and grievance procedure.

Employee classification is an important and complex piece of being a business owner, and that applies to dentists who own a practice. By a general principle, exempt employees possess management and decision-making responsibilities as a majority of their essential job functions (51 percent minimum).

Abuse represents a spectrum of behavior. It is repetitive in nature and fatal abuse is often preceded by minor manifestations of maltreatment, which could be overlooked by dentists and their staff. Under California law, each person licensed by the Dental Board of California and Dental Hygiene Committee of California is a “mandated reporter” for known or suspected abuse or neglect of a child, elder or dependent adult and incidents of violence.