OCR Settles Patient Discrimination Case About Discharge Communication

May 12, 2023 - In a case that shines a spotlight on patient discrimination, the Office for Civil Rights (OCR) within the Department of Health and Human Services (HHS) has reached a settlement with MCR Health resolving complaints of numerous patient non-discrimination protection violations.

A woman who is deaf and hard of hearing raised a flag against MCR Health. In her complaint, she accused the federally qualified health centers (FQHC) of not providing auxiliary aids and services, such as an interpreter, which she requested while accompanying her husband to a post-surgical appointment.

HHS and OCR expressed concern that the facility not only hindered effective provider communication with the caregivers but also posed potential risks to patient safety.

“Ensuring patient safety is at the heart of providing care in a quality and ethical manner,” OCR Director Melanie Fontes Rainer said in a public statement. “It should not take a federal investigation for a health care provider to provide an interpreter so that a patient’s caregiver can understand important information, such as a post-treatment plan.”

These accusations are seen as a violation of Section 504 of the Rehabilitation Act of 1973 and Section 1557 of the Patient Protection and Affordable Care Act. Under these laws, health centers like MCR Health, which receive federal financial support, are prohibited from discriminating based on disability.

As a result of the investigation, MCR Health entered into a voluntary resolution agreement to affirm its compliance with Section 504 and Section 1557. Under its corrective action plan, MCR must offer appropriate auxiliary aids and services whenever necessary to ensure effective communication with patients, companions, and members of the public who are deaf or hard of hearing.

The health system will also review its policy and related procedures, making any required revisions to implement the terms of the agreement and guarantee effective communication with patients and companions or caregivers who are deaf or hard of hearing.

In addition, MCR Health will prioritize the requests made by patients or companions who are deaf or hard of hearing, giving them primary consideration.

To track the denials of auxiliary aids and services, MCR Health will create a log, enabling the organization to monitor and address any instances where such aids and services are not provided.

“We are seeing case after case involving health care providers who fail in their responsibility under federal civil rights laws to provide effective communication to patients and their caregivers,” Rainer said. “This action supports OCR’s efforts to promote community integration by removing barriers to receiving services in the community.  OCR will continue to take robust enforcement action until we make it clear that health care providers must remove unnecessary barriers and provide equal treatment for those who are deaf or hard of hearing.”

This instance of disability bias is not isolated; discrimination is still an issue for many patients with disabilities as they interact with the healthcare system.

Even three decades after the enactment of the Americans with Disabilities Act (ADA), which prohibits healthcare discrimination based on disability status, patients with disabilities continue to face unequal access to care due to provider discrimination and implicit bias.

A study showed that a substantial number of physicians admitted to making strategic choices to deny care to individuals with disabilities. This includes making statements such as “I am not taking new patients,” “I do not take your insurance,” or telling the patients they need specialized care and therefore, “I am not the doctor for you.”

Another study demonstrated that nearly one-third of physicians lacked an understanding of their legal obligations under the ADA, leaving them liable to both legal infractions and perpetuating the health inequity and disparities experienced by individuals with disabilities.