Lance's Corner

OCR Takes Action Against Health Care Practice for Discriminating Against Hearing Disabilities

Jun 4, 2024

Per the notice below, the United States Office for Civil Rights (OCR) has taken action against a health care practice for discriminating against patients with hearing disabilities.

HHS Office for Civil Rights Takes Action to Ensure Access to Care for Patients Who Are Deaf or Hard of Hearing 

This is the latest action that OCR has taken to strengthen access to health and human services for people with disabilities. 

The U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR) announced a settlement with Englewood Ear Nose and Throat (Englewood) to ensure effective communication and access to services for individuals who are deaf or hard of hearing.  Englewood provides otolaryngology services, including the medical and surgical management of problems related to the ear, nose, and throat, for adults and adolescents in New Jersey.  The settlement was the result of OCR’s investigation of Englewood regarding allegations that it discriminated against people who are deaf and utilize American Sign Language as their primary means of communication.  Federal civil rights laws prevent discrimination against people with disabilities, including for sign language interpretation and when a person requests a companion to aid in a visit.  Under the terms of the settlement, Englewood agrees to take several actions that ensure equal treatment of patients who are deaf or hard of hearing.

“Individuals who are deaf or hard of hearing should be able to schedule medical appointments and be seen by medical professionals just as easily as any other patient,” said OCR Director Melanie Fontes Rainer.  “The law promises deaf and hard of hearing patients that they should receive care, free from discrimination, and have access to effective communication in appointments with their providers.  Today’s agreement puts other health care providers and facilities on notice to prioritize the communication needs of their patients and follow the law.”

OCR entered into the agreement under Section 504 of the Rehabilitation Act and Section 1557 of the Affordable Care Act, which prohibit discrimination on the basis of disability.  These laws specifically require health care providers to provide appropriate auxiliary aids and services to ensure that their communication with individuals with disabilities is as effective as their communication with others.  Under the terms of the agreement, the Office of Civil Rights will monitor Englewood for at least two years to ensure that it comes into compliance with the law.  Among other actions, Englewood specifically agrees that it will:

  • Furnish appropriate auxiliary aids and services free of charge to ensure effective communication for those individuals who request them;
  • Revise its non-discrimination policies and procedures to clarify how individuals can obtain services;
  • Provide training to personnel and staff on federal civil rights laws and update training materials so that staff are aware of patients’ rights and the hospital’s obligation to provide appropriate services;
  • Display notification to the public, patients and Englewood personnel of the rights and protections civil rights laws afford regarding nondiscrimination in healthcare and human services; and
  • Report progress of compliance with the settlement agreement to OCR through a series of compliance reports.

A copy of the Voluntary Resolution Agreement may be found here: https://www.hhs.gov/civil-rights/for-providers/compliance-enforcement/agreements/englewood/index.html.  OCR has taken several recent actions to strengthen access to health and human services for people with disabilities:

  • On April 26, 2024, OCR finalized the Section 1557 rule, which strengthens protections against discrimination on the basis of race, color, national origin, sex, age, and disability. 
  • On May 1, 2024, OCR finalized the Section 504 rule, substantively updating the rules for the first time in nearly 50 years.  Section 504 clarifies and strengthens civil rights protections for people with disabilities, addresses discrimination in medical treatment, adds enforceable standards for accessible medical diagnostic equipment, and ensures accessible web content and mobile apps.

To inform the public of their rights and encourage compliance with civil rights laws by the health care system, OCR has several Fact Sheets, FAQ’s and other resources.  Specific resources for deaf and hard of hearing services can be found here.  If you believe that you or someone else has been discriminated against for being deaf or hard of hearing, on account of another disability, or on account of race, color, national origin, age, sex, or religion, please file a complaint with the HHS Office for Civil Rights at https://www.hhs.gov/civil-rights/filing-a-complaint/index.html.

USDOL Issues Comprehensive Employer Guidance on Long COVID

The United States Department of Labor (USDOL) has issued a comprehensive set of resources that can be accessed below for employers on dealing with Long COVID.

Supporting Employees with Long COVID: A Guide for Employers

The “Supporting Employees with Long COVID” guide from the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) and Job Accommodation Network (JAN) addresses the basics of Long COVID, including its intersection with mental health, and common workplace supports for different symptoms.  It also explores employers’ responsibilities to provide reasonable accommodations and answers frequently asked questions about Long COVID and employment, including inquiries related to telework and leave.

Download the guide

Accommodation and Compliance: Long COVID

The Long COVID Accommodation and Compliance webpage from the USDOL-funded Job Accommodation Network (JAN) helps employers and employees understand strategies for supporting workers with Long COVID.  Topics include Long COVID in the context of disability under the Americans with Disabilities Act (ADA), specific accommodation ideas based on limitations or work-related functions, common situations and solutions, and questions to consider when identifying effective accommodations for employees with Long COVID.  Find this and other Long COVID resources from JAN, below:

Long COVID, Disability and Underserved Communities: Recommendations for Employers

The research-to-practice brief “Long COVID, Disability and Underserved Communities” synthesizes an extensive review of documents, literature and data sources, conducted by the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) on the impact of Long COVID on employment, with a focus on demographic differences.  It also outlines recommended actions organizations can take to create a supportive and inclusive workplace culture for people with Long COVID, especially those with disabilities who belong to other historically underserved groups.

Read the brief

Long COVID and Disability Accommodations in the Workplace

The policy brief “Long COVID and Disability Accommodations in the Workplace” explores Long COVID’s impact on the workforce and provides examples of policy actions different states are taking to help affected people remain at work or return when ready.  It was developed by the National Conference of State Legislatures (NCSL) as part of its involvement in USDOL’s State Exchange on Employment and Disability (SEED) initiative.

Download the policy brief

Understanding and Addressing the Workplace Challenges Related to Long COVID

The report “Understanding and Addressing the Workplace Challenges Related to Long COVID” summarizes key themes and takeaways from an ePolicyWorks national online dialogue through which members of the public were invited to share their experiences and insights regarding workplace challenges posed by Long COVID.  The dialogue took place during summer 2022 and was hosted by USDOL and its agencies in collaboration with the Centers for Disease Control and Prevention and the U.S. Surgeon General.

Download the report

Working with Long COVID

The USDOL-published “Working with Long COVID” fact sheet shares strategies for supporting workers with Long COVID, including accommodations for common symptoms and resources for further guidance and assistance with specific situations.

Download the fact sheet

COVID-19: Long-Term Symptoms

This USDOL motion graphic informs workers with Long COVID that they may be entitled to temporary or long-term supports to help them stay on the job or return to work when ready, and shares where they can find related assistance.

Watch the motion graphic

A Personal Story of Long COVID and Disability Disclosure

In the podcast “A Personal Story of Long COVID and Disability Disclosure,” Pam Bingham, senior program manager for Intuit’s Diversity, Equity and Inclusion in Tech team, shares her personal experience of navigating Long COVID symptoms at work.  The segment was produced by the USDOL-funded Partnership on Employment and Accessible Technology (PEAT) as part of its ongoing “Future of Work” podcast series.

Listen to the podcast

HHS OIG Issues Annual Report on State MFCUs

Per the notice below, the Office of the Inspector General (OIG) of the United States Department of Health and Human Services (HHS) has issued its annual report on the performance of state Medicaid Fraud Control Units (MFCUs).

Medicaid Fraud Control Units Fiscal Year 2023 Annual Report (OEI-09-24-00200) 

Medicaid Fraud Control Units (MFCUs) investigate and prosecute Medicaid provider fraud and patient abuse or neglect. OIG is the Federal agency that oversees and annually approves federal funding for MFCUs through a recertification process. This new report analyzed the statistical data on annual case outcomes—such as convictions, civil settlements and judgments, and recoveries—that the 53 MFCUs submitted for Fiscal Year 2023.  New York data is as follows:

Outcomes

  • Investigations1 - 556
  • Indicted/Charged - 9
  • Convictions - 8
  • Civil Settlements/Judgments - 28
  • Recoveries2 - $73,204,518

Resources

  • MFCU Expenditures3 - $55,964,293
  • Staff on Board4 - 257

1Investigations are defined as the total number of open investigations at the end of the fiscal year.

2Recoveries are defined as the amount of money that defendants are required to pay as a result of a settlement, judgment, or prefiling settlement in criminal and civil cases and may not reflect actual collections.  Recoveries may involve cases that include participation by other Federal and State agencies.

3MFCU and Medicaid Expenditures include both State and Federal expenditures.

4Staff on Board is defined as the total number of staff employed by the Unit at the end of the fiscal year.

Read the Full Report

View the Statistical Chart

Engage with the Interactive Map

GAO Issues Report on Medicaid Managed Care Service Denials and Appeal Outcomes

The United States Government Accountability Office (GAO) has issued a report on federal use of state data on Medicaid managed care service denials and appeal outcomes.  GAO found that federal oversight is limited because it doesn't require states to report on Medicaid managed care service denials or appeal outcomes and there has not been much progress on plans to analyze and make the data publicly available.  To read the GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the first link below.  To read GAO highlights of the report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the second link below.
https://www.gao.gov/assets/d24106627.pdf  (GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes)
https://www.gao.gov/assets/d24106627_high.pdf  (GAO highlights on federal use of state data on Medicaid managed care service denials and appeal outcomes)

CMS Issues Latest Medicare Regulatory Activities Update

The Centers for Medicare and Medicaid Services (CMS) has issued its latest update on its regulatory activities in the Medicare program.  While dentistry is only minimally connected to the Medicare program, Medicare drives the majority of health care policies and insurance reimbursement policies throughout the country.  Therefore, it always pays to keep a close eye on what CMS is doing in Medicare.  To read the latest CMS update on its regulatory activities in Medicare, use the link below.
https://www.cms.gov/training-education/medicare-learning-network/newsletter/2024-03-14-mlnc