APR 27 1998

The Honorable Dianne Feinstein
United States Senate
Washington, D.C.  20510-0504

Dear Senator Feinstein:

     I am replying to your inquiry on behalf of your constituent,
Ms. XXX              , whose office represents the San Ramon
Valley Primary Care Medical Group ("Medical Group").  Please
excuse our delay in responding.

     Ms. XXX    , on behalf of the Medical Group, has expressed
concern that health insurers do not reimburse physicians for
costs associated with a physician's obligation under the
Americans with Disabilities Act (ADA) to provide auxiliary aids
or services (specifically, sign language interpreters) for
persons with disabilities.  The Medical Group believes that the
ADA should require health insurers to reimburse medical
practitioners when they provide interpreter services.

     The terms and conditions of health insurance policies sold
by insurance providers who are public accommodations must comply
with the ADA.  However, the ADA does not expressly require a
medical insurer to reimburse health care providers for all
expenses incurred by an individual with a disability.

     Ms. XXX     letter to you enclosed a copy of a letter on this
issue that was sent to the Department of Health and Human
Services (HHS).  HHS, through the Health Care Finance
Administration, has a significant role in determining which
expenses constitute valid and acceptable insurer reimbursable
medical expenses.  HHS, pursuant to its overall regulation and
monitoring of the medical insurance industry, is the most
appropriate agency to determine which expenses should be
reimbursed as medical expenses.  We have been informed that HHS
is researching medical insurance payment schemes, including those
under the Medicaid/Medicare programs administered by the Health
Care Finance Administration.  HHS will reply directly to the
Medical Group.

(handwritten)FOIA

                                   -2-

     For your information, we have enclosed a copy of the
Department of Justice regulation implementing title III of the
ADA, tax credit information, the Title III Technical Assistance
Manual, and a Question and Answer flyer issued by the National
Center for Law and Deafness, an ADA technical assistance grantee
of the Department of Justice.  I hope this information is helpful
to you in responding to your constituent.  As you requested, we
have responded in duplicate.

                              Sincerely,

                            Bill Lann Lee
                    Acting Assistant Attorney General
                         Civil Rights Division

Enclosures