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What Health Care Providers Need To Know About Section 1557 of the Affordable Care Act

By Michael D. Magidson | Categories: Articles, Health LawPrint PDF October 2016

Many health care providers are just becoming aware of Section 1557 of the Affordable Care Act (i.e., the health care reform bill of 2010).  Generally, the rule prohibits discrimination in federally-funded programs and activities.  In many ways, this provision simply builds on current anti-discrimination laws but it is the first federal civil rights law to prohibit discrimination on the basis of sex in all federally-funded health programs and activities.  There is no de minimis exception in terms of number of employees so even solo physician practices (that accept federal funds) must comply with the rule.

There is, however, an exception that exempts entities with fewer than 15 employees from a requirement to have a grievance procedure or compliance coordinator; however, these entities would be well-advised to have such features in place for compliance with other laws, such as fraud and abuse and employment discrimination laws.

Most notably, Section 1557 requires entities covered by the rule to post notices of nondiscrimination containing certain “taglines” that alert individuals with “limited English proficiency” to the availability of language services in the top 15 non-English language spoken in the state in which the entity does business.  The government has published a list of such languages; however, health care entities may use any other reasonable methodology to determine the required languages.  There is no de minimis exception for a negligible amount of speakers in a certain area.

The final rule implementing Section 1557’s requirements was published on May 13, 2016 and the requirement to post the notices of nondiscrimination and the taglines goes into effect on October 16, 2016.  Please contact a member of our health care practice group with any questions regarding these requirements.


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