On July 18, 2016 new regulations under Section 1557 of the Affordable Care Act went into effect that prohibit physicians and other health care providers from discriminating against individuals on the basis of various factors and require notice of those rights. The regulation went into effect after nearly 25,000 comments were received and reviewed. (Physicians employed by health care entities covered by the regulations don’t have to provide the notices and policies described below, since the employer has that obligation.)

The requirements apply to all health programs and activities that:

• ·         Receive Federal financial assistance from DHHS;
• ·         Are administered by Health Insurance Marketplace entities; and
• ·         Are administered by DHHS (such as Medicare and Medicaid).

These new regulations codify requirements that already exist in more general terms, but they impose a new requirement that physicians provide a written notice of nondiscrimination to individuals. The notice must state that the physician’s practice:

• ·         Does not discriminate on the basis of race, color, national origin, sex [including gender identity], age [except for pediatric or gerontological specialists], or disability;
• ·         Provides free aids and services to people with disabilities to communicate effectively, such as sign language interpreters, written information in other formats; and
• ·         Provides language services to persons with limited English proficiency.

In addition, the notice must advise how those services may be obtained, contact information for the person responsible for grievance procedures (in offices of 15 or more employees), how to file a grievance, and how to file a discrimination complaint with the US DHHS Office for Civil Rights (OCR).

Covered entities may not rely on the person’s minor child to provide language services except in the case of a life-threatening emergency, nor may they rely on unqualified bilingual or multilingual staff or “low quality” video remote interpreting services.

This regulation by its terms does not apply to employment discrimination, which is covered elsewhere in state and federal law. Also, if the application of this regulation would violate federal laws protecting religious freedom and conscience, it need not be applied.

Finally, practices with 15 or more employees are required to designate a compliance coordinator who will investigate any grievances and adopt grievance procedures to address complaints.

The US DHHS Trainer’s Guide and PowerPoint slide deck on the new rules may be found on the DHHS website by clicking the links above. The website also has a notice form which is an appendix to the rule itself.