The US Attorney’s Office reached an agreement with the operator of 21 skilled nursing facilities in Massachusetts to resolve allegations that it violated the Americans with Disabilities Act (ADA) by turning away patients who indicated they were prescribed medications for Opioid Use Disorder (MOUD).
Individuals receiving treatment for Opioid Use Disorder (OUD) are generally considered disabled under the ADA, which, among other things, prohibits private healthcare providers from discriminating on the basis of disability. The United States alleges that the operator denied admission to 548 individuals who indicated they were prescribed MOUD while seeking admission to the operator’s programs. These individuals sought admission to the facilities for health issues unrelated to their addiction, but also required MOUD to treat their OUD.
Under the terms of the agreement, the operator will, among other things, adopt a nondiscrimination policy regarding the provision of services to individuals with disabilities, including individuals with substance use disorder (SUD) or individuals on MOUD, provide training on disability discrimination and SUD to admissions personnel, pay a civil penalty of $92,383 to the United States, $10,000 of which will be paid now and $82,393 of which shall be suspended and forgiven if the provider materially complies with the terms of the agreement.
This matter is part of an ongoing effort by the US Attorney’s Office to eliminate discriminatory barriers to treatment for OUD through ADA enforcement. This is the US Attorney’s Office’s 10th settlement agreement with a skilled nursing facility operator. The Office has now entered into 16 settlement agreements and six letters of resolution to ensure ADA compliance arising from OUD treatment.
Issue:
Under Title III of the ADA, no individual shall be discriminated against on the basis of disability in the full and equal enjoyment of the goods, services, facilities, privileges, advantages, or accommodations of a place of public accommodation. Specifically, discrimination includes the imposition or application of eligibility criteria that screen out or tend to screen out an individual with a disability or any class of individuals with disabilities from fully and equally enjoying any goods, services, facilities, privileges, advantages, or accommodations, unless such criteria can be shown to be necessary. A public accommodation may impose legitimate safety requirements that are necessary for safe operation, but safety requirements must be based on actual risks and not on mere speculation, stereotypes, or generalizations about individuals with disabilities. Refusing an individual admission to a facility based solely on the fact that they are being treated for OUD could be seen as a violation of Title III of the ADA.
Discussion Points:
- Review policies and procedures on discrimination and admission screening. Ensure that facility policies include prohibiting discrimination on the basis of any disability.
- Educate appropriate staff on Title III of the ADA and how denying admission to the facility based upon OUD could be seen as discrimination. Document that the trainings occurred and file the signed training document in each employee’s education file.
- Periodically audit for individuals who were denied admission to the facility to ensure that their denial was not in violation of Title III of the ADA.
