ACA Section 1557: A Comprehensive Overview for Healthcare Providers

On a recent evening, the Medical Society of New Jersey and Policymed.com hosted a pivotal webinar to discuss the 2024 final rule for ACA Section 1557 . This regulation, which came into effect on July 5, 2024, addresses non-discrimination in healthcare and poses significant implications for healthcare providers. The webinar was hosted by David Swee, MD , President of Medical Society of New Jersey, and featured prominent speakers, including Thomas Sullivan , Senior Vice President at Clinical Education Alliance; Stefanie Doyle , an associate at Baker Donelson; and Alexandra P. Moylan , a shareholder at Baker Donelson.

Understanding the 2024 Final Rule

Stefanie Doyle began the presentation by outlining the history and evolution of ACA Section 1557. The 2024 final rule builds upon previous regulations from 2016 and 2020, introducing several key changes:

1. Expanded Definition of Sex Discrimination: The rule now explicitly prohibits discrimination based on gender identity and sexual orientation. It mandates that healthcare providers cannot impose restrictions on care based on a patient’s gender identity or sex assigned at birth.
2. Inclusion of Medicare Part B Providers: For the first time, the rule includes Medicare Part B recipients as covered entities, expanding the scope of the regulation significantly.
3. Affirmative Actions Required: Providers must take proactive steps to inform patients of their rights and protect them from discrimination. This includes expanding assistance for individuals with limited English proficiency and disabilities.
4. Non-Discrimination in Telehealth: The rule emphasizes that telehealth services must be provided without discrimination, ensuring that individuals with disabilities have equal access to these services.

Compliance and Enforcement

Ms. Doyle explained that the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) will enforce the rule. If a violation is found, OCR will first seek voluntary corrective action from the provider, which may include revising policies and procedures and/or implementing training and monitoring programs. If a covered entity refuses to take corrective action, non-compliance can result in the suspension or termination of federal financial assistance, or in a referral to the Department of Justice for enforcement proceedings. Additionally, the rule supports a private right of action, allowing individuals to sue providers for non-compliance.

Specific Requirements for Providers

All providers, regardless of size, must develop and implement written policies to facilitate compliance, including non-discrimination policies, language access procedures, and procedures for providing auxiliary aids and services.

Providers with more than 15 employees must designate a Section 1557 Coordinator who is responsible for ensuring compliance with the rule. The coordinator will handle grievances, coordinate training, and oversee the implementation of policies and procedures.

Language Access: Providers must ensure meaningful access to services for individuals with limited English proficiency. This involves providing qualified interpreters and translators and ensuring that critical documents are accurately translated.

Training: Relevant employees, including those in patient care, financial services, and executive leadership, must be trained on the new civil rights policies and procedures. This training must be completed within 300 days of the rule’s effective date (May 1, 2025).

Addressing Discrimination in Clinical Decision Support Tools

Alexandra Moylan highlighted the importance of addressing potential biases in clinical decision support tools, including AI and machine learning systems. Providers must ensure that these tools do not incorporate discriminatory practices based on race, gender, or other protected characteristics. Efforts should be made to identify and mitigate biases, to ensure fair and equitable treatment for all patients.

Q&A Session Highlights

During the Q&A session, several critical points were addressed, including:

• Translation Services: Providers must offer free translation services to all patients, not just those covered by Medicare. This requirement aims to ensure that language barriers do not impede access to healthcare.
• Training and Compliance: Smaller practices must also comply with the rule, and the required training should cover all relevant employees, including those in non-patient-facing roles.
• Implementation Challenges: Webinar participants raised concerns about the practical challenges of implementing these requirements, especially for smaller practices and those serving diverse communities. The speakers emphasized the importance of leveraging resources from professional organizations and pooling resources where possible.

Conclusion

The 2024 final rule for ACA Section 1557 represents a significant step forward in promoting non-discrimination in healthcare. While the new requirements pose challenges for healthcare providers, they also offer an opportunity to improve access and equity in healthcare services. The Medical Society of New Jersey’s webinar provided valuable insights and practical guidance for navigating these changes, emphasizing the importance of proactive compliance and patient-centered care.

For more detailed information and resources, healthcare providers can visit Policy and Medicine, where this article and the webinar recording will be available. As the healthcare landscape continues to evolve, staying informed and prepared will be crucial for ensuring compliance and providing high-quality care to all patients.

Additional Resources and Upcoming Training

Thomas Sullivan concluded the webinar by directing attendees to additional resources available on Policy and Medicine . These include comprehensive articles, updates on regulatory changes, and links to further reading on ACA Section 1557.

Moreover, the Medical Society of New Jersey, in collaboration with the Clinical Education Alliance, is offering an upcoming course on the ACA 1557 new requirements and courses for DEA licensure , which includes eight hours of substance use disorder and opioid management training. This course, along with New Jersey state required courses on controlled substances, aims to help healthcare providers meet their continuing education requirements and stay compliant with the latest regulations.

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For more information on these courses and to access the webinar recording , slides and related articles , visit Policy and Medicine. The Medical Society of New Jersey is committed to supporting healthcare providers through these regulatory changes and ensuring that all patients receive equitable, high-quality care.? ?Clinical Care options is preparing courses to help healthsystems and healthcare providers training for updates and more information, please send an email to [email protected]

Webinar Recording

Slides from Webinar

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