Are You in Compliance?

Since its implementation in 2010, the Affordable Care Act has gone through dozens of revisions, with each new presidential administration choosing to implement certain policies in different ways while also abiding by the decisions made by Congress and the Supreme Court. Most recently, the Biden administration made a final rule on the implementation of section 1557 of the ACA, which is dedicated to prohibiting discrimination in health care and insurance providers based on race, color, national origin, age, disability, or sex. While much of the provision was fully implemented in 2016, a good portion of it was later rolled back in 2020. This recent decision restores much of the original acts provisions while expanding the scope in certain areas.

While there are many issues this new initiative tackles, such as transgender healthcare and abortion access, two areas we would like to highlight is the administration’s stance on healthcare access for both the disabled and for individuals with limited-english proficiency. As these rulings are constantly in flux, it’s important to understand what is a revitalization of the original 2016 implementation, and what is a completely new policy

What’s the Same: Compliance with The ADA

One of the essential provisions of the original Affordable Care Act was how it sought to reaffirm the Americans with Disabilities Act’s role in keeping healthcare accessible and comprehensible to disabled citizens. A core aspect of this was ensuring that insurance companies could not deny coverage to individuals with pre-existing conditions. In order to enforce said policy, the government can suspend all federal funding to any health care provider who accepts Medicare or Medicaid. This section also highlights that private businesses who do not accept federal funding are still beholden to the ADA, and must ensure all aspects of their business, from their storefront to their website, are accessible for disabled individuals. To read more about what is expected of private institutions when it comes to ADA regulations, you can read about the ADA’s website regulations by clicking here.

What’s New: ADA and Telehealth

Since the COVID-19 pandemic, the use of telehealth has spiked in popularity, as more and more patients choose to use either their phones or their computers to interface with medical professionals for diagnoses and prescriptions. To keep in line with current trends, the new implementation of Section 1557 addresses telehealth tools, emphasizing that these tools must be as easily accessible for disabled patients as they are for the rest of the patient body. This means that they must be compliant with screen-reader software, and must also be easily navigable for patients with limited mobility and motor functions. It also has provisions set in place to ensure that the use of AI tools do not create a hostile user environment, and that access to a human representative is always an option.

What’s the Same: Interpretation for Limited English Individuals

Another large portion of the original ACA, as well as its 2020 implementation, was its coverage of patients with limited English proficiency and what is expected of medical institutions when dealing with them. In its current implementation, the Act requires that medical institutions provide language services free of charge and must make an effort to ensure said services are accurate, timely, and protect the privacy of the individual using them. It also ensures that institutions cannot force patients to provide their own interpreters, and that organizations cannot rely on bilingual staffing in order to fill the role of a qualified interpreter. Unfortunately, what is deemed to be a qualified interpreter is slightly ambiguous, as many languages lack concrete certification programs at the national level, so what can be seen as a “qualified interpreter” is up to the opinion of both the institution and the patient.

What’s New: Technological Developments in Language Services

A key addition in this newest round of implementation is a strict series of guidelines for video interpretation services. These guidelines ensure that, if a patient is interested in video interpretation, that said interpretation must have both high quality audio and video, and that all parties involved can effectively understand one-another. Another interesting provision within the new act is how it handles AI translation. Recent trends point to more and more medical institutions relying on machine learning models to translate their medical documents. While this process has greatly enhanced the speed at which medical professionals can receive foreign documents related to their patients, the lack of human oversight is cause for concern. To ensure that all information being translated is accurate, the ACA requires that all machine translated documents are reviewed and edited by a qualified human translator when the text is critical to protecting an individuals rights and health, especially if said documents are complex or contain technical language.