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ADA urges members to contact members of Congress regarding final rule on Sec. 1557

Organized dentistry weighs in: We 'respectfully request a delay'

July 29, 2016

By Jennifer Garvin

Washington — The Organized Dentistry Coalition has asked the U.S. Department of Health and Human Services' Office for Civil Rights for an extension of the implementation deadlines for the recently released final rule on Section 1557 of the Affordable Care Act.

Section 1557 prohibits 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. The final rule, which was implemented July 18, applies to health care providers who receive certain funds through HHS, including Medicaid and the Children's Health Insurance Program. It does not apply to providers who only receive reimbursement under Medicare Part B, but as of July 18 the agency had not clarified whether the rule applies to dentists who receive reimbursement under Medicare Part C, also known as Medicare Advantage.

In a July 29 letter to Jocelyn Samuels, OCR director, the coalition urged the agency to delay the enforcement date so that dentists will have sufficient time to meet the requirements. The coalition signees included the ADA; American Association of Endodontists; American College of Prosthodontists; American Academy of Pediatric Dentistry; American Association of Women Dentists; American Society of Dentist Anesthesiologists; Academy of General Dentistry; American Academy of Oral and Maxillofacial Pathology; American Association of Oral and Maxillofacial Surgeons; American Academy of Periodontology; National Dental Association; American Association of Orthodontists; and Hispanic Dental Association.

In the letter, the coalition wrote that the "extremely short" implementation timeline has made compliance with the final rule exceedingly difficult, "especially because OCR staff have not addressed several questions regarding the rule."

The coalition stressed that it "strongly supports nondiscrimination in health care and equal access to health care for all patients without regard to race, color, national origin, sex, age, religion or disability" but said it is concerned that the final rule will negatively affect patient access to care, "particularly in impoverished communities, because health care providers may hesitate to accept the extra compliance burdens and liability risks that the final rule imposes on providers who participate in government health care programs, such as Medicaid."

For these reasons, the coalition said it "respectfully requests a delay in the enforcement date until there is sufficient time to allow for our members to meet the requirements." It also requested relief for "our members working in small practice settings and request the most burdensome regulations be limited to those who employ 25 or more staff."

This is not the first time organized dentistry has reached out to OCR. In November 2015, the ADA submitted comments regarding the proposed rule, noting that it was "confusing, duplicative and burdensome, as well as unnecessary." Since then, "OCR staff made few changes to the proposed rule, and these concerns have not changed," wrote the coalition.

The Association continues to advocate for members in regards to the final rule. On July 29, ADA emailed some 40,000 grassroots members, urging them to write their member of Congress to ask HHS Secretary Sylvia Burwell to delay implementation of the rule.

In an ADA letter to Ms. Samuels, ADA President Carol Gomez Summerhays and Executive Director Kathleen T. O'Loughlin noted that since 70 percent of ADA members practice in solo settings and employ an average of 4.9 employees, compliance within the "extremely short timeline afforded by the OCR" is difficult.

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.

To learn more about contacting your local representatives, visit the ADA's Engage Legislative Action Center and sign up to receive critical updates on the Association's key advocacy issues. The ADA uses Engage to send out action alerts, inform dentists on critical public policy issues and put members in contact with legislators.

For more information, visit the OCR's website and search Section 1557.