Section 1557: New Rule Unveiled to Enhance Nondiscrimination in Health Care

The U.S. Department of Health and Human Services (HHS), through its Office for Civil Rights (OCR) and the Centers for Medicare & Medicaid Services (CMS), has announced a final rule under Section 1557 of the Affordable Care Act (ACA). This significant update is set to strengthen nondiscrimination protections within the healthcare sector, as it expands upon measures that ensure equitable access to healthcare services.

The new rule not only aims to restore protections that were diminished by previous administration efforts but also introduces additional provisions to combat discrimination and improve equity of care in both physical and digital realms. This includes addressing biases present in emerging health technologies such as artificial intelligence.

Key Updates to Section 1557 Impacting Language Access Include:

• Proactive Communication: Healthcare providers, insurers, and grantees must inform patients that language assistance and accessibility services are available at no cost. This ensures that individuals are aware of the resources available to them.
• New & Improved Terminology: The final rule adopted the term “individual with limited English proficiency” instead of “limited English proficient individual.” Several commentors noted that an individual with LEP includes those who may be competent in English for certain types of communication but still have limited English proficiency for other purposes. This change ensures providers and other covered entities understand that people who have some English competency may still need translated written materials.
• Expanded Digital Accessibility: The rule mandates that all health programs and activities provided through telehealth must be accessible, so as to support individuals with limited English proficiency and those with disabilities.
• Clarification on Insurance: The application of nondiscrimination requirements to health insurance plans is explicitly clarified, ensuring that all individuals receive equitable treatment under their health plan.
• Artificial Intelligence and Health Technology: With increasing use of AI in health care, the rule specifies that nondiscrimination policies apply to AI, clinical algorithms, predictive analytics, and other decision support tools used in patient care. Importantly, a translation must be reviewed by a qualified human translator if machine translation is used in the following scenarios: 1) When the information is critical to the rights, benefits, or meaningful access of an individual with limited English proficiency; 2) When accuracy is essential; 3) When the source documents or materials contain complex, non-literal or technical language.

We invite you to visit our LinkedIn page to learn more about our Machine Translation Post-Editing (MTPE) solutions that can help you stay in compliance.

Statements from HHS Leadership:

Secretary Xavier Becerra expressed his support for the new rule, stating, "Today’s rule is a giant step forward for this country toward a more equitable and inclusive healthcare system and means that Americans across the country now have a clear way to act on their rights against discrimination when they go to the doctor, talk with their health plan, or engage with health programs run by HHS.”

OCR Director Melanie Fontes Rainer added, “Section 1557 is critical to making sure that people in all communities have a right to access health care free from discrimination.”

She shared insights from her travels around the United States, where she encountered numerous stories of discrimination in healthcare. “The robust protections of 1557 are needed now more than ever,” she said.

These enhancements to Section 1557 are expected to foster a more inclusive and just healthcare environment, addressing the nuances of modern healthcare needs, and ensuring that discrimination has no place in health services across the nation.

To learn more about how this new ruling might affect your organization, please contact your account executive or schedule a consultation with one of our language experts.

Upcoming Webinar

Interested in learning more about updates to the language access provisions in Section 1557?

Please join us on Wednesday, May 29 at 11am PT/2pm ET for our webinar, Navigating Changes: Section 1557 of the ACA. The webinar will feature Mara Youdelman, Managing Attorney for Federal Advocacy at the National Health Law Program.

Ms. Youdelman is an esteemed subject matter expert on language access in health care and will be available to answer all Section 1557-related questions.