{ legislative & regulatory } What’s In a Membership Benefit? I
f you’ve read any of the ADA’s Morning Huddle emails over the course of the last few months, or seen the multiple emails the MDA has sent out, you’re familiar with Section 1557 of the Affordable Care Act (ACA). To summarize: it re- quires those who receive fed- eral or state reimbursement for either Medicare or Med- icaid (in addition to a few other assistance programs) to post a notice in their prac- tice of non-discrimination. It also requires within that non-discrimination that providers be responsible for securing and paying the cost for translator services if they have a limited English proficient (LEP) patient whose primary language is one of the top 15 in the state of Missouri.
As more members became aware of the impending requirements in Section 1557, the MDA received an in- creased number of calls on a weekly basis. We spoke with the ADA about what other states were doing about the new regulations; we found out that a few states allow for translator services to be reimbursed by their Medic- aid programs. Knowing that we can’t alter or amend what is included in the ACA, and specifically Section 1557, we decided to see if there was a way we could help our members by lobbying for these reimbursable transla- tor services.
14 focus | SEP/OCT 2016 | ISSUE 5 MISSOURI STATISTICS
ACA Estimates of the Top 15 Languages Spoken by Individuals with Limited English Proficiency for Missouri
PRIMARY LANGUAGE RANK Spanish Chinese
1 Vietnamese
Serbo-Croatian German Arabic Korean Russian French Tagalog
Pennsylvanian Dutch Persian (Farsi) Cushite
Portuguese Amharic
2 3 4 5 6 7
8 9
10 11 12 13 14 15
Vicki Wilbers, MDA Execu- tive Director, and I explained the issues and concerns to Missouri State Dental Director, Dr. John Dane. We asked him about whether it was likely Missouri would reimburse for these services to give providers a break from the potential exorbi- tant costs associated with the new requirement. He suggested reaching out to Dr. Joe Parks, Director of MO HealthNet, directly. Vicki penned a thoughtful and informative letter to Dr. Parks just last week (early September) and we are hope- ful that our request that he consider reimbursing for translator services, much like other states, does not fall on deaf ears. Obviously, should anything come of this letter, we will keep you, our valued member, apprised.
These actions are just one more example of how your membership benefits you. You contact us with con- cerns, we formulate a plan and take action accordingly. Even as we speak, our legal team is devising a plan of how to broach the subject of the Silent PPO and non- covered services statute vio- lations that were addressed in this month’s issue exactly one year ago. The survey we sent out in August 2015 re- ceived more than 200 com- plaints, which showcased exactly how much insurance carriers’ dishonest practices affected our membership. Again—you spotlight the issue, we take action.
Being an MDA member means you have individu- als who bring you the best in CE courses, provide you the most up-to-date oral healthcare information and news, both nationally and statewide, lobby for your profession on behalf of you, and take the time to hear your concerns and pass them along to those who have the ability to address them. These are just a few of the many benefits of being an MDA member. Thanks for letting us serve you! f
Contact Katie at katie@modentalmail. org. Plan to join her at Legislative Day in January!
Take Note Section 1557 Update
The final rule under Section 1557 of the ACA is a concern for members. Many provi- sions of the rule went into effect July 18, while others take effect October 16. One of the rule’s requirements is that covered entities must post taglines in the top 15 non-English languages spoken in their state, which is a short statement that indicates that language assistance services, free of charge, are available.
Although the Office for Civil Rights (OCR) has provided a sample tagline, the ADA developed a more targeted sample tagline related to language assistance services. Currently the ADA tagline is being trans- lated into the languages needed to comply with the tagline requirement and will be available by the time this issue is received.
Translations of the OCR sample tagline are available on its website. Taglines are not required until October 16, thus allow- ing members sufficient time to post the ADA’s taglines, which will be available in a convenient state-by-state format. Covered entities may develop their own taglines, as long as the tagline is compliant with the final rule. The covered entity would need to have the tagline translated into the top 15 languages in its state.
Several members have inquired about docu- menting patient encounters where an in- terpreter or translator were necessary, and/ or coding for interpretation or translation services. In addition to including narrative in the patient record, beginning in 2017, a new CDT code can be used. D9994 dental case management—patient education to improve oral health literacy will be available.
Members can view all of the ADA’s Section 1557 resources at
ADA.org/1557.
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52