Are pay­ers, providers ready for HHS’ trans­gen­der anti-bias rules?

Modern Healthcare - - THE WEEK AHEAD - —Vir­gil Dick­son

Providers and pay­ers across the coun­try will be ex­pected to ad­here to a new HHS pol­icy this week that pre­vents dis­crim­i­na­tion against pa­tients based on their gen­der or gen­der iden­tity.

Start­ing July 18, trans­gen­der peo­ple can en­ter bath­rooms or hos­pi­tal wards con­sis­tent with their gen­der iden­tity. The rule does not ex­plic­itly re­quire in­sur­ers to cover gen­der-tran­si­tion treat­ments such as surgery. But in­sur­ers could face ques­tions if they deny med­i­cally nec­es­sary ser­vices re­lated to gen­der tran­si­tion.

The pol­icy, which car­ries out anti-bias pro­vi­sions in the Af­ford­able Care Act, af­fects any provider or pro­gram that ac­cepts fed­eral dol­lars. Yet in the days lead­ing up to im­ple­men­ta­tion of the rule, there were few signs that providers were ready.

“I have not seen a lot of ev­i­dence of (hospitals) ac­tively de­vel­op­ing po­lices and prac­tices around (the rule) so far,” said Tari Han­ne­man, deputy di­rec­tor of the health and ag­ing pro­gram for the Hu­man Rights Cam­paign.

In March, the HRC found that only 21% of U.S. hospitals have spe­cific poli­cies out­lin­ing pro­ce­dures and prac­tices to elim­i­nate bias and in­sen­si­tiv­ity to­ward trans­gen­der pa­tients.

The rule em­pow­ers HHS to sus­pend or ter­mi­nate fed­eral fund­ing to any or­ga­ni­za­tion that does not ad­dress non­com­pli­ance. HHS may also con­tact the U.S. Jus­tice Depart­ment to de­ter­mine a crim­i­nal of­fense.

Re­li­gious hospitals may find the rule es­pe­cially re­stric­tive and sev­eral sub­mit­ted com­ments dur­ing the rule­mak­ing. But it’s un­likely any hos­pi­tal would ul­ti­mately walk away from hun­dreds of mil­lions in fed­eral re­im­burse­ment, Han­ne­man said. HHS did not of­fer a blan­ket re­li­gious ex­emp­tion.


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