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November 21, 2024
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New DOJ Rule Requires Medical Facilities to Make Diagnostic Equipment Disabled-Friendly

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Some groups have raised concerns the rule could push up costs for small practices and hospitals, potentially affecting operations.

The U.S. Department of Justice (DOJ) has made it mandatory for public medical entities to maintain medical equipment which can accommodate disabled individuals in an attempt to ensure people are not refused care because of their condition.

The Americans with Disabilities Act (ADA) requires that people with disabilities are not denied benefits of services run by state or local government entities.

On Aug. 9, the Justice Department published a final rule revising ADA to ensure that Medical Diagnostic Equipment (MDE) used at hospitals and health care clinics operated by state or local governments can be accessed by disabled people as well.

MDE includes equipment such as dental chairs, weight scales, mammography machines, and medical examination tables.

“Without accessible MDE, individuals with disabilities may not be afforded an equal opportunity to receive medical care, including routine examinations, which could have serious implications for their health,” the final rule states.

“A lack of accessible MDE may also undermine the quality of care that individuals with disabilities receive, delay the provision of medical care, exacerbate existing medical conditions, and increase the likelihood of developing secondary medical conditions.”

The final rule stated that people with disabilities have had to avoid taking Pap smears—a screening tool for cervical cancer—because they could not be safely transferred from wheelchairs onto examination tables.

Breast cancer screening rates among disabled individuals have been low due to inaccessible mammography machines, it said.

The new rule establishes certain minimum technical criteria that MDEs used in physicians’ offices, clinics, emergency rooms, hospitals, and other medical settings must adhere to.

All new MDE that local and state government entities buy, lease, or acquire after Oct. 8 must be accessible by disabled people.

In addition, if these entities use examination tables and weight scales, they must have at least one examination table and weight scale that can be accessed by people with disabilities by Aug. 9, 2026.

Entities should also have qualified staff at the place of service who can operate accessible MDEs.

“This rule marks a significant milestone in our ongoing efforts to ensure that people with disabilities can get the medical treatment they need,” said DOJ Assistant Attorney General Kristen Clarke of the Civil Rights Division, according to a July 26 press release.

Boon for Disabled, Concerns About Costs

When the Justice Department proposed the rule in January, it received support from several groups.

Cure SMA, a nonprofit that supports patients and families affected by spinal muscular atrophy, welcomed the rule, saying it “applauds DOJ for its effort to reduce barriers and promote equal access to quality healthcare for people with disabilities,” according to its Feb. 7 comments submitted to the department.

It cited the experience of an adult spinal muscular atrophy patient who had to go to multiple clinics until they could find one capable of accommodating them. Another patient said she had to experience “long waits” at clinics.

The Blinded Veterans Association (BVD) announced that it “strongly supports” the new rule.

In addition to ensuring a uniform code for local and state medical entities dealing with disabled people, the rule also provides “an important baseline” that can be referenced by private healthcare providers while caring for people with disabilities, it said.

The rule was criticized by the American Medical Association (AMA) in February. It pointed out that the costs of acquiring MDE are borne upfront, which represents “an immediate and substantial cost burden” for small practices.

DOJ’s calculation that the annualized costs for small entities complying with the MDE requirement would be less than 1 percent of their annual revenues is only an “average” number, the organization noted.

“Small entities often operate under increasingly thin operating margins, so even a 1 percent annual reduction could be significant to their bottom line, particularly when coupled with other financial pressures such as increasing workforce and supply costs and significant reductions in Medicare physician payments.”

The AdvaMed Medical Imaging Division, which represents manufacturers of medical imaging equipment, also raised concerns about the costs of updating MDE requirement.

The financial and operational impact on small hospitals “could be profound,” it said. Many of these entities may not have the resources to replace or upgrade existing diagnostic imaging equipment.

“This could lead to reduced availability of essential diagnostic services for patients in rural and underserved areas, contrary to the rule’s intent to increase accessibility,” the group said.

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