Legislative Update – Section 1557 of the ACA

Nurse helping elderly woman walk down hallwaySection 1557 prohibits discrimination on the basis of race, color, national origin, sex, age or disability in certain health programs and activities. The final rule on Section 1557 of the Affordable Care Act (ACA) was released in July 2016 and establishes new standards for implementation.

Who is affected?
The final ruling applies to any health program or activity that receives funding from HHS including: Hospitals or health systems accepting Medicare and or Medicaid; doctors accepting Medicare or Medicaid; health programs administered by HHS; Health Insurance Marketplaces; and health insurance or group health plans participating in Health Insurance Marketplaces.

The final ruling:

  • Includes gender identity discrimination within the definition of sex discrimination and extends protections against sex discrimination to health coverage and care for the first time
  • Codifies long-standing guidance regarding meaningful access for individuals with Limited English Proficiency (LEP) and specifically says each organization that receives Medicare and Medicaid dollars must notify people with LEP that they have the right to free, accurate and timely language assistance services in addition to providing the appropriate services. These notifications or taglines must be printed in the respective state’s top languages on “significant communications”. i.e., brochures, posters, postcards, etc.
  • Incorporates existing law that requires organizations to notify patients and members of the availability of reasonable modifications, effective communication and readily accessible buildings and IT services to avoid disability-based discrimination
  • Prohibits health insurance benefit designs to discriminate and offers specific coverage protections for transgender patients and members

When do you have to comply with the final ruling?

Doctors, hospitals and health systems should have been compliant by October 16, 2016. Health insurance or group health plans must be compliant by Jan. 1, 2017.

Are you compliant?
Our team of 175+ professionals dedicated to healthcare and in-depth knowledge of this issue can help you achieve compliance quickly. Get in touch.

About the Author

Arundi Venkayya is marketing and public relations manager for Taylor Healthcare, curator of EngagingPatients.org and administrator of the Sherman Award program which recognizes excellence in patient and family engagement. Before joining Taylor Healthcare, Arundi was an editor at the Dayton Daily News and served as public relations manager for Dayton Children's Hospital.

Arundi Venkayya has 12 post(s) at Healthcare Blog

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