Upcoming November 2nd Deadline for RHCs: Section 1557 Nondiscrimination Rule
Shriya Velichala, NARHC Intern
Earlier this year, the Department of Health and Human Services (HHS), through the Office of Civil Rights (OCR), released the Nondiscrimination in Health Programs and Activities final rule, regarding Section 1557 of the Affordable Care Act (ACA). The final rule “prohibits discrimination on the basis of race, color, national origin, sex, age, or disability,” and applies to any healthcare provider that “receives Federal financial assistance,” which includes Medicare, Medicaid, CHIP, or any Affordable Care Act Marketplace plans.
NARHC has resources available, including a previous article and webinar, that provide a more comprehensive overview of the provisions of this final rule and how they impact RHCs. Here we will focus specifically on two of the provisions that are relevant to RHCs and have deadlines approaching this year – the naming of a Section 1557 Coordinator (if you have 15 or more employees) and the Notice of Nondiscrimination requirement.
Note: The Section 1557 regulations are currently unenforceable in Texas and Montana due to ongoing legal challenges against the rule. RHCs in TX and MT must still be compliant with the law, in that they do not discriminate "on the basis of race, color, national origin, sex, age, or disability,” but do not need to be compliant with these specific provisions outlined below.
Section 1557 Coordinator and Grievance Procedure
One of the key provisions of this rule requires that entities with 15 or more employees must have a Section 1557 Coordinator. The coordinator’s responsibilities include:
- receiving and reviewing grievances;
- coordinating Section 1557 recordkeeping requirements;
- coordinating language access procedures;
- coordinating effective communication procedures;
- coordinating procedures for providing reasonable modifications for individuals with disabilities; and
- coordinating training of relevant employees
The rule also requires that providers establish a civil rights grievance procedure, giving patients away to voice their concerns to providers.
RHCs with 15 or more employees must have a Section 1557 Coordinator and a grievance procedure in place by November 2, 2024.
Notice of Nondiscrimination
The second provision that must be met by November 2nd requires RHCs to have a Notice of Nondiscrimination that provides information on compliance with nondiscrimination policies. The notice must include that:
- the covered entity does not discriminate on the basis of race, color, national origin, sex, age, or disability;
- the covered entity will provide reasonable modifications for individuals with disabilities, appropriate auxiliary aids and services, and language assistance services, free of charge and in a timely manner. It must also include information on how to obtain these services from the entity;
- include the contact information for the Section 1557 Coordinators (if applicable);
- include the availability of the covered entity’s grievance procedure and how to file a grievance (if the facility has 15 or more employees);
- provide details on how to file a discrimination complaint with OCR in the Department; and
- include information on how to access the covered entity’s website (if applicable)
The Notice of Nondiscrimination must be provided to all patients on an annual basis and upon request. It must be provided in no smaller than 20-point sans serif font and be posted on the website in a “conspicuous” location and in the office in a “prominent” physical location. It is only required to be posted in English, but covered entities are required to provide translations as necessary to provide meaningful access.
The OCR has provided a sample notice that entities can edit and customize to fit their organization.
As a reminder, RHCs are required to be compliant with these provisions by November 2, 2024. Please contact Sarah.Hohman@narhc.org with any questions.
Additional Resources
