HHS Issues Final Rule Implementing Section 1557 of ACA

Jackson Walker

Jackson Walker


Section 1557 of the Affordable Care Act (ACA) prohibits discrimination on the basis of race, color, national origin, sex, age, or disability. While the provision has been in effect since the ACA was passed in 2010, the US Department of Health and Human Services (HHS) has recently issued a final rule for Section 1557, creating new obligations for healthcare facilities that receive “Federal financial assistance.” HHS was concerned that certain communities throughout the US were faced with barriers to healthcare. As such, this new rule focuses on ensuring easier access for those individuals.

The obligations created by this rule apply to “Covered entities,” which is defined to include those entities that operate a health program or activity, any part of which receives Federal financial assistance, as defined in the final rule, and entities established under Title I of the ACA.


While Section 1557 of the ACA prohibits Covered entities from discriminating on the basis of race, color, national origin, sex, age, or disability, HHS has further required Covered entities in this newly issued rule to do the following:

  1. Post a nondiscrimination notice in key locations;
  2. Post taglines in 15 different languages, indicating the availability of language assistance services;
  3. Put a nondiscrimination notice and taglines on significant publications;
  4. For covered entities that employ 15 or more people, establish a grievance procedure and designate an employee to be in charge;
  5. Train certain employees on compliance with Section 1557;
  6. Provide meaningful access for individuals with limited English proficiency;
  7. Provide auxiliary aids/services to patients with impaired sensory, manual, or speaking skills; and
  8. Submit an assurance of nondiscrimination when applying for Federal financial assistance.

Covered entities that do not follow the HHS requirements or that discriminate illegally in violation of Section 1557 can be liable for compensatory damages, subjected to civil actions and have their federal assistance suspended or terminated.

Effective Date

The rule implemented by HHS went into effect on July 18, 2016. However, Covered entities were provided a 90-day grace period for the posting of notices and taglines and establishing a grievance procedure, making their actual effective date October 16, 2016.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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