Letters: Thoughts on Sec. 1557
August 21, 2017
I am gratified that the ADA has asked U.S. Department of Health and Human Services to take another look at the Sec. 1557 final rule and point out the “confusing and duplicative” nature of its intent and wording (“Office for Civil Rights Meets With Health Care Groups, Receives Input on Sec. 1557,” June 5 ADA News). Without a doubt, more regulations, especially when they are duplicative and confusing, almost always add costs and create potential — and usually frivolous but predictable — legal and regulatory entanglements for the dental profession.
The rule is meant to prevent discrimination based upon “race, color, national origin, sex, age, or disability and in health programs or activities that receive federal financial assistance.”
Of course, no dentist should discriminate against any patient for whom they are trained and able to treat properly. And I believe 99 percent of all dentists share that belief, practice in that manner and perform a huge amount of quiet charitable care everyday in our practices.
However, as one of those dentists and small business owners, the actual text might concern members. It states:
Sec. 1557 extends nondiscrimination protections to individuals participating in:
• Any health program or activity any part of which received funding from HHS.
• Any health program or activity that HHS itself administers.
• Health Insurance Marketplaces and all plans offered by issuers that participate in those Marketplaces.
This sounds an awful lot to me like a precursor to requiring all dentists to participate in any government run plan. I am hopeful that our organization has sought and gained clarification on these three items.
Will HHS make re-licensure contingent upon taking Medicaid patients? Will we be required to accept fees that do not allow us to treat these patients properly and to our standards?
Not being privy to internal discussion, perhaps this has been addressed.
But in case it has not, I am hopeful that we can gain a better understanding soon and take possible action to clarify these few words. They may be just a few words, but open a huge door into our personal practice decisions.
Joel L. Strom, D.D.S.
Editor’s note: While a dentist is generally obligated to bill Medicare for covered services unless the dentist has opted out of Medicare, the Sec. 1557 final rule does not require a dentist to participate in federally funded health programs.