- On April 29, 2024
On Friday, April 26, 2024, the federal Department of Health and Human Services’ Office of Civil Rights released a final regulation addressing the nondiscrimination in health insurance provisions of the Affordable Care Act (ACA). Known colloquially as the “Section 1557 Nondiscrimination Rules,” this measure governs how the ACA’s ban prohibiting health insurers and federal health programs from discriminating based on race, color, national origin, age, sex, and disability applies to any health-related program under the federal Department of Health and Human Services, including Medicare, Medicaid, CHIP, and the federal health insurance marketplace.
When Section 1557 of the ACA was initially rolled out during the Obama Administration, HHS took a broad approach and applied the rule to any entity that participated in or got federal funding from an HHS-administered health program. These rules were dialed back during the Trump Administration and have also been the subject of several federal lawsuits. The new final rule broadens the measure’s reach and clarifies many of the points litigated over the years.
Highlights include:
- Establishing that HHS’ health programs and activities are subject to the ACA’s nondiscrimination standards, as well as entities that get any funding or financial assistance from a federal health insurance program (such as a health insurer that benefits from federal premium tax credit subsidies).
- Designating Medicare Part B payments as a form of federal financial assistance for purposes of triggering the rules so that healthcare providers and suppliers receiving Part B funds are prohibited from discriminating based on race, color, national origin, age, sex, and disability.
- Requiring covered health care providers, insurers, grantees, and others, to proactively let people know that language assistance services are available at no cost to patients.
- Requiring covered health care providers, insurers, grantees, and others to let people know that accessibility services are available to patients at no cost.
- Establishing that covered health programs and activities offered via telehealth must also be accessible to individuals with limited English proficiency and individuals with disabilities.
- Codifying that Section 1557’s prohibition against discrimination based on sex includes LGTBQI+ patients.
- Clarifying that the Section 1557 nondiscrimination requirements apply to health insurance plans that benefit from federal funding.
- Applying the nondiscrimination principles under Section 1557 to the use of patient care decision support tools in clinical care.
- Requiring those covered by the rule to identify and mitigate discrimination when using AI and other forms of decision-support tools for care.