Section 1557 of the Affordable Care Act prohibits discrimination in health care and health coverage on the basis of race, color, national origin, age, disability and sex. It applies to all health programs that receive federal dollars such as Medicare and Medicaid. Although consistent in many ways with civil rights laws prohibiting discrimination in other settings, Section 1557 contains some unique provisions. For example, “sex discrimination” under Section 1557 includes discrimination based on gender identity in health care. This is the first time that a federal law prohibits discrimination of this type in patient care. In addition, Section 1557 and its accompanying regulations create a new focus on national origin discrimination by highlighting the language barriers that individuals with limited English proficiency may face. Under Section 1557, providers must take steps to give individuals with limited English proficiency meaningful access to health care. This includes offering those in need of language assistance with written translations and interpreter services when requested.
In furtherance of its purpose, Section 1557 and its regulations require practices to adhere to a number of requirements by October 16, 2016:
- Practices must prepare and post a Notice of Nondiscrimination alerting patients to their rights under Section 1557 and informing them that communication assistance is available if needed.
- Practices must post short “Taglines,” notifying patients with limited English proficiency of available language assistance services. These Taglines must be written in the 15 most often used non-English languages in the practice’s state.
- The Notice of Nondiscrimination and the Taglines must be displayed in a conspicuous location within the practice’s office, on the practice’s website, and in significant materials and publications.
- Practices must also adopt a Statement of Nondiscrimination. This is to be included in the Notice of Nondiscrimination, as well as in any smaller-sized significant materials and publications, such as pamphlets and postcards. Smaller-sized significant materials and publications must also include Taglines in the two most often used non-English languages in the practice’s state.
- Practices must develop a Grievance Policy to address any discrimination issues or concerns patients may raise related to Section 1557’s requirements. Any practice with 15 or more employees must also identify a compliance coordinator to investigate any complaints made pursuant to the Grievance Policy.
Now is the time to take the necessary steps to comply with these requirements. The Department of Health and Human Services Office of Civil Rights will require non-compliant practices to take corrective action and may impose compensatory damages in actions brought to enforce Section 1557. Although the Department of Health and Human Services has forms and materials on its website, practices with questions or concerns would be prudent to discuss them with an experienced healthcare attorney. Practices should also consider training their employees on the basics of Section 1557 so that they are familiar with these new rules. The attorneys in Houston Harbaugh’s healthcare practice group are available to advise your practice on Section 1557 compliance questions and conduct trainings for your organization.