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Section 1557: Do you comply with the ACA’s Non-discrimination Requirements?

This week, new requirements under Section 1557 of the Affordable Care Act went into effect for certain health care and coverage providers. If you’re not familiar with Section 1557, it’s the non-discrimination part of the ACA and applies to:

  1. Any health program or activity, any part of which receives funding from HHS (such as hospitals that accept Medicare or doctors who accept Medicaid);
  2. Any health program that HHS itself administers;
  3. Health Insurance Marketplaces and issuers that participate in those Marketplaces.*

That “applies to” cuts a broad swath. While Section 1557 has been in effect since 2010, the HHS final rule “to improve health equity” goes further in defining non-discrimination. If you fall into any one of the three categories above, ask yourself:

  • Do you provide care for women and men equally? Do you charge the same for equal service, regardless of gender?
  • Have you, or do you, ever deny care (or coverage for care) because of someone’s gender? Gender identity? Pregnancy? Do you stereotype?
  • How do you help patients (or members) with limited English skills access and understand their care or coverage?
  • For those with disabilities, how do you make sure they can easily access not only facilities, but also electronic information that relates to their care (or coverage)?

There’s ample opportunity and need for employee and management training on these requirements. HHS OCR’s materials, including FAQs in multiple languages, can help. You can download those here. An update to your compliance program materials, including policies and procedures, may also be in order.

Sources:
*Summary: Final Rule Implementing Section 1557 of the Affordable Care Act(pdf)
Press release re HHS Final Rule on Section 1557

Apgar and Associates  can help you with questions and concerns about your privacy and security compliance program, including updates and training, at 877-376-1981. Apgar and Associates is also the home of the compliance consulting subscription program for qualifying organizations.

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