The AAFP's reaction to a newly proposed regulation offered by HHS' Office of Civil Rights was quick and to the point: Either fund the costs small physician practices would bear to comply with the portion of the rule regarding interpreters -- estimated at $1,135 per practice per year -- or eliminate the offending requirement.
The proposed rule(www.gpo.gov) -- titled "Nondiscrimination in Health Programs and Activities" -- would implement a section of the Patient Protection and Affordable Care Act.
In a Nov. 6 letter(2 page PDF) to HHS Secretary Sylvia Burwell, AAFP Board Chair Robert Wergin, M.D., of Milford, Neb., noted the AAFP's overall support of the rule, which aligns with several longstanding Academy policies that encourage health care coverage for all and oppose discrimination.
But the proposal also would require health care entities, including family physicians, to ensure effective communication with their patients with disabilities, including calling for the provision of "enhanced language assistance for people with limited English proficiency," said Wergin.
- The AAFP told HHS in a recent letter regarding a proposed rule that the government must provide funding for interpreter services or drop the mandate to practices.
- The proposed rule on nondiscrimination in health programs and activities would require practices to provide interpreter services and would cost small practices an estimated $1,135 a year.
- AAFP Board Chair Robert Wergin, M.D., made it clear that the AAFP is a strong supporter of culturally proficient health care and the inclusion of cultural and ethnic topics in medical and residency training curriculum.
Make no mistake: The AAFP strongly encourages culturally proficient health care and has specific policy that addresses such issues and encourages medical schools and residency training programs to include cultural and ethnic topics in their curriculum, said Wergin.
However, the AAFP also has long supported government funding for mandated interpreter services and has called for such payments to be made directly to interpreters providing the service.
"Because small practices already operate on such thin margins, the AAFP strongly believes that HHS must procure the necessary funding to address and offset the estimated $1,135 burden on small entities," said Wergin.
"We have significant concerns that primary care practices are already taking a financial loss for treating patients who require interpretive services," he added, pointing to the historical undervaluation of primary care services under the resource-based relative value scale system.
Wergin insisted that payment for the provision of essential primary care services was "simply inadequate" and that interpretive services were costly. "If the patient reschedules or does not appear for the appointment, the practice must still reimburse the interpreter," he added.
HHS must provide funding to practices to cover their costs related to compliance with the rule -- or do the right thing and simply eliminate that portion of the proposed rule, Wergin concluded.
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