Lance's Corner

OCR Director Highlights Access to Health Care

Jan 11, 2025

Per the notice below, the Director of the United States Office for Civil Rights (OCR) highlights OCR accomplishments and OCR resources and initiatives on increasing access to health care.

Protecting Civil Rights and Access to Health Care

By Melanie Fontes Rainer, Director for Office for Civil Rights

The belief in and commitment to making access to health and human services a reality for everyone—regardless of a person’s sex, race, color, national origin, disability or age—is a cornerstone of our mission at the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR) and why my staff and I have worked hard, day in and day out, to fulfill this mandate.  It has been an honor of a lifetime to serve as part of an Administration which places value on people first, no matter who you are, where you live, or who you love.  As a fifth generation Arizonan and Mexican American woman raised by a single mom, that mattered to me and motivated me every day to lead and advocate for people across the country.

Since day one at OCR, we aimed to strengthen protection of civil rights, health information privacy and security, and implement and enforce the law as a top priority—bringing this work outside of Washington, DC, directly to our communities and neighborhoods across the country where it matters the most—visiting 30 states and one territory, to be exact.  Because, what good is a right, if you don’t know you have that right, you don’t understand your right, or that right is not being properly prioritized in your community?  That’s where OCR’s work comes in and why it is so important.  We are here to help ensure that every person across the nation has access to the critical health care and human services that they need, free from discrimination.

OCR’s largest complaint volume comes from individuals who cannot access their medical records.  That’s why OCR rigorously enforces the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule’s Right of Access, a critical tool to empower patients to use access and use their own data to drive their health.  And no matter which city I was in, West Coast or the Great Plains, language access and effective communication always came up when I talked with patients and providers.  People with disabilities would share their stories with me about a hospital that denied them a companion in the emergency room, or how they worked so hard to get accessible medical equipment for their wheelchairs to have an MRI, only to face staff that day who did not know how to use it.  Time and again, I heard about appointments canceled because no interpreter was available for a person whose primary language is not English.  Or children being forced to interpret for their family member.  These quickly became priority areas for us and drove us to create and implement policy changes to address these scenarios people face every day: through the new Section 504 of the Rehabilitation Act Rule, which we updated for the first time in nearly five decades; or the new Section 1557 of the Affordable Care Act Rule, which addresses discrimination throughout HHS health programs and activities; or steering language access across HHS to develop and roll out HHS departmentwide and division-specific language access plans to ensure and expand language access across the health care sector – for the first time in a decade; and more.

One of my proudest achievements was working alongside the U.S. Department of Justice and the Alabama Department of Public Health to improve public health in Lowndes County.  There, we witnessed how a lack of sanitation systems contributes to public health concerns, and we are working together with the State to address it.  Lowndes County is sacred ground for our nation’s civil rights history; being able to use our civil rights laws to drive change shows the power of our partnership and our joint determination to put communities first.  We also worked with the Puerto Rico Department of the Family on changing its practices, training, and work to improve effective communication for children and families in its child welfare system.  Our visit enabled us to meet with community members to talk about civil rights and health information privacy and security.

In 2024, OCR resolved 22 HIPAA enforcement actions through settlement agreements and civil monetary penalties, collecting over $9.9 million—second highest completed enforcement actions in OCR history—demonstrating our unwavering commitment to enforcing HIPAA—our nation’s law to protect your health information and secure our health care systems.  And just last month, we issued a draft rule to update the HIPAA Security Rule to improve the cybersecurity enforcement, practices, and resiliency of our health care system – a major national security priority amid exponential increase in cyberattacks.

Even as we worked to move OCR forward, when new problems occurred affecting how people receive care, we were ready to do everything we could to help people.  In 2022, when Roe v. Wade was overturned, I was at the last abortion clinic in St. Louis, MO, alongside Secretary Becerra.  There, we saw in real time the impact of the loss of this important health care right as the clinic we were in scrambled to make changes and inform their patients.  Later, I also shared my own story when OCR released its final rule, the HIPAA Privacy Rule to Support Reproductive Health Care Privacy, which will help protect patient confidentiality and promote trust between patients and providers.

As we reflect on our accomplishments, it’s important to remember OCR’s commitment of upholding fairness and justice through the law, from HIPAA to our civil rights laws.  If you want to file a complaint about a violation, contact the Office for Civil Rights at 800-368-1019, TDD: 1-800-537-7697, by e-mail at OCRMail@hhs.gov, or visit www.hhs.org/ocr.  It has been an opportunity of a lifetime to serve the American people in this role, and I have been so privileged to work with our mighty civil servants nationwide who day in and day out work for you.  Please never forget you are not alone!  OCR is here to help.

Melanie

OCR’s Rules:

Complaint Filing

If you believe that you or someone else has been discriminated against because of race, color, national origin, disability, age, sex, or religion in programs or activities that HHS directly operates or to which HHS provides federal financial assistance, or if you believe that your or another person's health information privacy or civil rights have been violated, you can file a complaint with the HHS OCR at: www.hhs.gov/ocr/complaints.

HHS Blog Post: https://www.hhs.gov/blog/2025/01/10/protecting-and-championing-civil-rights-every-person-and-their-access-equitable-health-care-across-america.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