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Non-Discrimation Notices – Deadline October 19, 2016

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See below for an update from CMA regarding the posting of Non-Discrimination Notices.


This week, we have received a number of calls from members with questions about CMAs alert on the requirement to post nondiscrimination notices. This e-mail is intended to provide additional information to help you answer any questions you may receive.

The U.S. Department of Health and Human Services (HHS) Office of Civil Rights (OCR) recently finalized new nondiscrimination rules intended to advance health equity and reduce health care disparities. The rule, which implements section 1557 of the Affordable Care Act, includes important protections for individuals with disabilities and enhances language assistance for people with Limited English Proficiency (LEP).
This final regulation does not change current law which incorporates existing Title VI regulations and Department of Health and Human Services’ Limited English Proficiency policy. Current law is outlined in CMAs Legal On-Call #6003 (attached)
Title VI of the Civil Rights Act provides that any program or activity (including healthcare professionals) that receives federal funds must take reasonable steps to ensure meaningful access to their activities by persons with limited-English proficiency. An example of a current Title VI requirement: Physicians are already required to provide access to language interpreter services.  If the physician is contracted to provide care with a Medi-Cal Managed Care Plan, the plan may be providing the service.  Otherwise, physicians providing services through Fee-For-Service Medi-Cal would be required to provide the service.
Physicians should already be in compliance with the existing Title VI provisions required under current law.
New Requirements
The final rule includes new requirements with respect to nondiscrimination postings and grievance procedures.  Physicians need to be in compliance with the rule by October 19, 2016.
Who does the rule apply to?
This rule applies to those who provide or administer health-related services or insurance coverage and receive “federal financial assistance.” Federal financial assistance includes Medicare, Children’s Health Insurance Program, Medicaid, meaningful use payments, HHS grants, Centers for Medicare and Medicaid Services gain-sharing demonstration projects, federal premium and cost-sharing subsidies, etc.
The rule does not apply to physicians who participate only in Medicare Part B, unless they are also receiving meaningful use incentive payments.
What are the new requirements?
Covered physicians are expected to:
·          Post a notice of nondiscrimination and taglines in the top 15 languages spoken by individuals with limited English proficiency
·         Develop and implement a language access plan
·         Designate a compliance coordinator and adopt grievance procedures (applicable to group practices with 15 or more employees)
·         Submit an assurance of compliance form to OCR
What happens if a covered provider does not comply with the new rule?
In addition to administrative enforcement mechanisms, such as loss of federal financial assistance, individuals are permitted to bring individual or class action violation claims in federal court directly against physicians who are not in compliance with these rules.
Next Steps
To assist with implementation, OCR has translated into 64 languages a sample notice and taglines for use by covered entities. In addition, OCR has published a summary of the rulefactsheets on key provisions and a list of frequently asked questions.
The California Medical Association (CMA) has sought guidance from the California Department of Health Care Services to determine what languages California physicians must post for the nondiscrimination notice. As additional information becomes available, CMA will provide more detailed instructions about how physicians may comply with this rule.
Please let me know if you have any questions.
Lishaun Francis
Associate Director
Center for Health Policy
California Medical Association
1201 J Street, Sacramento, CA 95814
(800) 786-4262
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