The information included in this issue of Risk E-Notes is intended to provide members with a general introduction to a few of the procedural requirements impacting Covered Entities under Section 1557 of the ACA. It is not intended as exhaustive or comprehensive treatment of this subject or as legal advice.
We anticipate receiving additional information from the California Department of Public Health on several key issues including the 15 predominant languages spoken in the state of California.
As information becomes available, we will continue to update our members via CAPsules, Risk E-Notes and the CAP website. Links to government websites and other articles are included as additional resources.
On May 13, 2016, the Department of Health and Human Services (HHS) issued a final rule that implements Section 1557 of the Affordable Care Act (ACA). Section 1557 is the first federal civil rights law to broadly prohibit discrimination based on gender identity in federally funded health programs receiving federal financial assistance. The Nondiscrimination in Health Programs and Activities final rule provides that women must be treated equally to men when receiving healthcare and insurance. Additionally, individuals cannot be denied care or coverage based on sex, including gender identity and sex stereotyping. For example, coverage exclusions or limitations for healthcare services based on gender transitions are discriminatory; individuals must be treated consistent with their gender identity.
The rule also requires covered entities to physically post taglines in the top 15 languages spoken by people of limited English proficiency (LEP) in their state, indicating the availability of language assistance services. According to ECRI Institute, “[p]hysicians and other healthcare providers must ensure that they are able to provide care in consideration of their population's culture and language needs, and in consideration of any disabilities. This necessarily involves staff training, access to interpreters, printing of signs and forms in various languages, and arranging for nontraditional services as requested”.
Covered entities with 15 or more employees are required to adopt a grievance policy and designate a compliance coordinator. A designated compliance officer could be your office manager, practice manager, senior staff, HIPAA Privacy Officer, or yourself. The CMA has included a model grievance policy for your review and use also.
This article is a summary of HHS's Final Rule on Nondiscrimination in Health Programs and Activities.
This article 'Physicians must post nondiscrimination statements by Oct. 19. 2016' from the California Medical Association (CMA) summarizes the legal requirements and provides the following important links:
- Sample notice and taglines
- Summary of the rule
- Fact sheets on key provisions
- Frequently asked questions
CAP will provide updated information as it becomes available.
This information should not be considered legal advice applicable to a specific situation. Legal guidance for individual matters should be obtained from a retained attorney.