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November 2016

About Section 1557: Interpreter/Anti-discrimination Rules

If your practice accepts payment under any Medicare or Medicaid plan (including the Healthy Michigan Plan and Healthy Kids Dental), it now falls under the provisions found in Section 1557 of the Affordable Care Act, which prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in health programs or activities that receive federal assistance.

Under Section 1557, effective July 18, 2016, your practice is responsible for these provisions:

  • Post a notice of nondiscrimination in the dental office and on your practice website. A sample notice is available for download from the U.S. Department of Health and Human Services website.
  • Post taglines in the dental office and on the practice website indicating that language assistance services are available free of charge. The compliance date for the notices is 90 days after the effective date, or October 16, 2016.

    The taglines must be made available in the 15 most common languages spoken in the state. Translated sample taglines can be found on the website. You will only need to add the correct phone number. The top 15 non-English languages for Michigan are: Spanish, Arabic, Chinese, Syriac, Vietnamese, Albanian, Korean, Bengali, Polish, German, Italian, Japanese, Russian, Serbo-Croation, and Tagalog.
  • Arrange for translator services if necessary and requested. It is recommended that you contact the dental or health plan to inquire if services are available. If a translator service is necessary, the provider is responsible for any associated costs and may not bill the patient. The state of Michigan offers a free directory of translation services in Michigan, otherwise you can do an internet search for translation services.

The American Dental Association has posted Section 1557 compliance resources online including a Section 1557 webinar.

How Long Should Dental Records be Maintained?

Michigan law requires that dental records be kept for 10 years from the last date of treatment to which the record pertains. In a sale transaction, typically the selling dentist assigns custody of all records to the purchasing dentist (this would depend on the actual language contained in the sale documents). The purchasing dentist then becomes obligated to maintain all the records assigned for the remainder of the 10-year period.

If the dentist having custody of the records is deceased, the obligation continues. If the records are less than 10 years old when the dentist dies the obligation to keep them for 10 years survives and whoever has custody of the records succeeds to that obligation.

MDA member dentists have access to complete information about dental records retention in the Legal Services section of the MDA website.

Procedures for Dismissing a Patient

One of the most difficult challenges in a practice is knowing when to dismiss or “divorce a patient.” It’s an emotional task to do since most of your patients are like family.

There are many reasons and situations that take place to start the thought of dismissing a patient. But once the decision has been made the next step is how to handle the dismissal.

There is definitely a right and wrong way to sever this tie, because you do not want to put the dentist at risk for an abandonment claim.

First, be professional. Even if this patient has been disruptive to the practice you still want to present the practice in a professional light. Second, you need to protect the dentist. Here are six basic steps to avoid an abandonment claim:

  • Put the separation in writing.
  • Provide the patient with some explanation for terminating the relationship.
  • Offer to continue treatment and access to services for a reasonable period of time.
  • State that the dentist will provide emergency services for a period of time.
  • Offer to transfer the patient’s records to a new dentist.
  • Help the patient find another dentist.

The Michigan Dental Association offers its members a free Patient Dismissal Packet, which includes details, tactics, procedures, and sample letters. Click here to email your request for a free information packet.