Compliance TODAY December 2013 A PUBLICATION OF THE HEALTH CARE - PDF document

Compliance TODAY December 2013 A PUBLICATION OF THE HEALTH CARE COMPLIANCE ASSOCIATION WWW . HCCA - INFO . ORG Timothy Ferriss Jan Cunningham Compliance Specialist – Privacy Director of Risk Management Alaska Native Tribal Health Consortium Compliance Offjcer, Qualis Health A discussion on celebrating Corporate Compliance & Ethics Week See page 16 23 28 36 40 Compliance Tax-exempt hospitals: Physician-owned Compliance and offjcer and the Putting your entity fraud alert: quality of care, Part 1: audit committee: hospital’s IRS Hospital compliance Laws and case studies Building an effective exemption at risk offjcers take note Michelle Moses Chaitt, Mark L. relationship Gerald Griffjth, James King, Tom Bulleit, Eliza Andonova, Mattioli, Richard E. Moses, Steven Forman and Catherine E. Livingston and Natalie D. Morris and D. Scott Jones This article, published in Compliance Today , appears here with permission from the Health Care Compliance Association. Call HCCA at 888-580-8373 with reprint requests.

by Radha V. Bachman Compliance 101: Recent settlements should compel provider review of ADA auxiliary aid compliance » The Americans with Disabilities Act (ADA) applies to the vast majority of healthcare providers in the U.S. » Auxiliary aids must be provided to patients and/or their companions at no charge. » Family members should not be requested to serve as qualifjed interpreters. » Discussions regarding non-clinical matters (e.g., billing or legal issues) may also require the provision of auxiliary aids. » Top-down staff training on ADA compliance should be performed regularly. these two agencies has allowed them to target Radha V. Bachman (rbachman@carltonfjelds.com) is an Associate in the their enforcement efforts on a critical area for Health Care practice of Carlton Fields, PA, in Tampa, FL. individuals who have disabilities—access to A string of enforcement actions and medical services and facilities. In the 12 months public settlements in recent months since the announcement, the Initiative seems to have given health care providers have achieved desired traction and healthcare across the country fair warning—Americans providers, from physician practices to large with Disabilities Act (ADA) enforcement is on health systems, are scrambling to ensure that its way. 1 Since the July 2012 ADA Barrier-Free their current policies and procedures refmect Health Care Initiative (Initiative) was the ADA’s requirements. In announcing settle- announced, there have been a total ments, Eve L. Hill, Senior Counselor to the of 14 publicly disclosed enforcement Assistant Attorney General for the Civil Rights actions against healthcare providers, Division was quoted as saying: with the largest settlement to date reaching $140,000. 2 All types of healthcare providers—from The Initiative was pursued by the hospitals to nursing homes, from surgeons federal government as a mechanism Bachman to general practitioners—all across the coun- Compliance Today December 2013 for putting enforcement muscle behind try—need to provide equal access to people ADA requirements, and it allowed two federal with disabilities, including people who are bodies (i.e., the U.S. Attorneys’ Offjce and the deaf. More than 20 years after passage of the Civil Rights Division of the Department of ADA, the time for compliance is now. 3 Justice) to leverage their respective resources in pursuing non-compliance among provid- The widespread exposure of these recent ers. Specifjcally, the collaboration between settlements may leave providers of every 888-580-8373 www.hcca-info.org 71

shape and size fjelding compliance-related have the effect of denying equal access questions from attentive patients. As such, this to disabled individuals; · article is meant to provide a brief overview Furnish individuals with auxiliary of the ADA requirements related to visu- aids when necessary to ensure effective ally and hearing impaired people and, based communication; · on recent settlements, focus on some of the Remove architectural and structural most important aspects of the regulation for communication barriers in existing healthcare providers. facilities; and · Provide equivalent transportation Healthcare providers services and purchase accessible vehicles as public accommodations in certain circumstances. The ADA is a federal civil rights law that pro- hibits discrimination against individuals by Auxiliary aids private entities that fall under the defjnition of Nine of the settlements entered into since July “public accommodations,” including, but not 2013 have focused on the provision of auxiliary limited to, lodging, food and drink service, aids and services to deaf or hearing impaired theaters, retail outlets, amusement parks and, individuals. Auxiliary aids and services may of course, healthcare providers. 4 The ADA include the provision of qualifjed interpreters, estimates that there are more than fjve million assistive listening headsets, television caption- public accommodations currently operating ing, brailled and large print materials, among in the U.S. today, with a sizeable percentage of other things, and these are to be provided to those constituting healthcare providers. The certain individuals at no charge. 5 In requir- ADA also applies to public entities, including ing healthcare providers to provide auxiliary public hospitals and clinics. As a result, the aids, the government reasoned that such aids vast majority of healthcare providers, regard- are often needed in order to provide safe and less of size, status, or number of employees, are effective medical treatment to the hearing and required to make their services available to the visually impaired. Without the use of these public in an accessible manner and in compli- aids, both providers and consumers run grave risks, such as misdiagnosis or misunderstand- ance with the ADA. ings regarding symptoms. Similarly, patients Specifjcally, both Title II, which is appli- may not understand specifjc medical instruc- cable to public entities, and Title III, which is tions or adhere to prescription limitations applicable to public accommodations, gen- erally require the following of healthcare or warnings. Such results can have a serious providers, including hospitals: impact on an individual’s health or well–being. · Provide goods and services in the most Public accommodations may be exempt from integrated setting appropriate to the the requirement to provide auxiliary aids, pro- needs of the individual; vided that they can demonstrate that taking Compliance Today December 2013 · Remove unnecessary eligibility standards the required steps would fundamentally alter or rules that deny individuals with the nature of the goods, services, or facilities or disabilities an equal opportunity to would result in an undue burden. participate in the goods and services In making determinations as to whether offered by the public accommodation; and to what extent auxiliary aids are neces- · Provide reasonable modifjcations in sary in treating the hearing and visually policies, practices, and procedures may impaired, providers should take into account 72 www.hcca-info.org 888-580-8373