How does the Affordable Care Act Section 1557 translate for dental and medical service providers?

Affordable Care Act Section 1557 Impact is changing the languages that dentists and doctors speak to their patients who use Medicare and Medicaid.

On May 18, 2016 the US Department of Health and Human Services published the final rules implementing the anti-discrimination provision of the ACA, the Affordable Care Act.

You can read the final rules in full from the Federal Register here. In a nutshell, Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in health programs.

The rule applies to doctors and dentists who accept Medicare and Medicaid.  Paragraph 92.201 regulates “Meaningful Access for Individuals With Limited English Proficiency.”  The rule also states that each state is responsible for providing translations for the top 15 non-English languages spoken in their state.

Even more interesting, is that each state has it’s own diverse language line up.

For instance, the top 15 languages in Texas are:

Texas Language Stats by population:

1 Spanish** 2,966,475 2 Vietnamese 115,640 3 Chinese 71,139 4 Korean 30,852 5 Arabic 22,002 6 Urdu 18,041 7 Tagalog 17,982 8 French 12,673 9 Hindi 12,656 10 Persian ◘ 11,610 11 German 10,664 12 Gujarati 9,864 13 Russian 7,004 14 Japanese 6,620 15 Laotian 5,709

Did you guess right?

But if you live in neighboring New Mexico, you’ll need to brush up on your Navajo.

New Mexico Language Stats by population:

1 Spanish 152,981 2 Navajo 10,292 3 Vietnamese 2,727 4 German 1,488 5 Chinese 2,205 6 Arabic 766 7 Korean 717 8 Tagalog 697 9 Japanese 563 10 French 548 11 Italian 390 12 Russian 319 13 Hindi 275 14 Persian 271 15 Thai 238

Source: Centers for Medicare & Medicaid Services: https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/Appendix-A-Top-15.pdf

Dental Industry Push Back

In response to the implementation of the ruling, the Organized Dentistry Coalition which represents 13 different dental professional organizations including the ADA, requesting relief from practitioners with limited staff and resources.

Source: ADA http://www.ada.org/~/media/ADA/Advocacy/Files/160729_hhs_sec1557_discrimination.pdf

Medical Industry Loophole

According to the HealthAffairs.org blog, if a physician accepts Medicare Part B, Section 1557 would not reach physicians who receive Medicare Part B payments but no other federal funding.

Clearly there are questions.

Source: http://healthaffairs.org/blog/2016/01/06/section-1557-of-the-aca-should-not-allow-some-physicians-to-discriminate/

Language Service Solution Providers

As the dust settles and compliance becomes the challenge, the medical and dental communities would be smart to engage with a language service provider and discuss “on demand” service options and costs.  Which parts are scalable? Can a healthcare service provider join a coalition of small service providers who pool resources for on demand services?

There is always a solution for those who seek a solution. Everything has a cost. While this ruling may provide some hurdles to overcome, think about what it would mean to your community to be able to serve the “long tail” market. Those who are not in the majority, but seek quality service providers.

A language service provider can provide you with cost saving, efficient options that serve the greater good.

We welcome the opportunity to work with you to address ACA Section 1557 and how offering your practice to the community in their native language will drive business to you like never before.

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