Final Section 1557 Rule
Nondiscrimination in Health Care Programs and Activities

By: Donald R. Moy, Esq.

Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA).  This law prohibits discrimination on the basis of race, color, national origin, sex, age or disability in health programs or activities.

Section 1557 builds on long established Federal  civil  rights laws and extends these nondiscrimination protections to individuals participating in:

 - Any health program or activity any part of which receives federal financial assistance from the U.S. Department of Health and Human Services (HHS) ;

 - Any health program or activity that HHS has involvement in administering;

 -Health Insurance Marketplaces and all plans offered by issuers that participate in those Marketplaces.

For example, hospitals that accept Medicare or doctors who receive Medicaid payments or who receive other federal financial assistance are included as "covered entities" under the Final Rule.

Section 1557 has been in effect since its enactment in 2010 and the HHS Office of Civil Rights has issued a final rule to implement section 1557, which was published in the Federal Register on May, 18, 2016.  The Final Rule became effective on July  18, 2016.

Among the requirements of the Final Rule, covered entities must post notices of nondiscrimination and taglines  that alert individuals with limited English proficiency to the availability of language assistance services.  The Office of Civil Rights has translated a sample notice and taglines for use by covered entities  into 64 languages.
For translated materials, visit the following link:

The notice requirement cecomes effective within 90 days of July 18, 2016, on October 16, 2016.

The Final Rule also requires covered entities with 15 or more employees to have a grievance procedure and a compliance coordinator. The Final Rule includes a model grievance procedure.

Is your medical practice a Covered Entity under the Final Rule?  Does participation in Medicare part B or receipt of payments under Medicaid make a doctor's office a covered entity?  Although HHS in the Final Rule takes the position that a doctor's participation in Medicare Part B alone does not constitute federal financial assistance, HHS takes the position that receipt of payment  under Medicaid constitutes federal financial assistance, and HHS estimates that the vast majority of doctors are covered entities because they receive payments from Medicaid or receive  federal financial assistance through other means.  For more information, read the attached article.

You may download the full article by clicking Download File in the top left of this page.