Compliance Services

Affordable Care Act Section 1557

Frequently asked questions

What is Section 1557?

Section 1557 is the nondiscrimination provision of the Affordable Care Act. It prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in health programs and activities (including health education and health research programs). Health programs and activities are required to ensure that consumers have equal access to health care services and health coverage provided by the Affordable Care Act. The implementing regulation was issued on May 18, 2016.

What rights do consumers have under Section 1557?

Patients and consumers are entitled to equal access to health programs, services and activities. Covered entities are barred, among other things, from excluding, refusing or adversely treating individuals in health programs, services and activities on the basis of race, color, national origin, sex, age, or disability. In addition, individuals with limited English proficiency (LEP) and individuals with disabilities must be provided meaningful access to health programs, activities and benefits. The intent of the rule is to eliminate known barriers that are based upon discrimination, reduce disparities in the provision of services and benefits and to help advance equity in health programs and activities for the above noted protected classes.

Under what circumstances is different treatment or exclusions regarding the participation of protected classes permissible in health education and health research programs?

Section 1557 does not prohibit health research programs or activities based upon protocols supported by objective evidence and empirical data that target or exclude certain populations/groups in order to account for the health or safety of the subjects, study design or the purpose of the research (e.g., a clinical trial to study the impact of a drug on male subjects may exclude women from the test group). Contact Karen Moe for information or questions. Email: Phone: 206-543-7246

What is meaningful access?

Health programs, services and activities must take affirmative steps (i.e., offering necessary and appropriate auxiliary aids and assistance services) to ensure that individuals with limited English proficiency and individuals with disabilities have equal access to the services, activities and benefits offered. For example, individuals with LEP must be offered language assistance services such as oral or written translations to ensure they are provided necessary and important medical information and health care programs and activities offered electronically must be accessible to individuals with disabilities using adaptive software and equipment and made available using an alternative means of access (e.g., a person with a disability who is unable to use a clinic’s on-line appointment system is provided contact information to schedule an appointment by phone). The assistance services provided must be free of charge, accurate and timely, and must protect the privacy and independence of the individual.

Which UW departments and/or units must comply with Section 1557?

Section 1557 applies to every health program, service or activity within an entity that receives HHS funding or other federal financial assistance, every health program or activity administered by HHS, such as the Medicare Part D program, and the Health Insurance Marketplaces. Examples of covered entities include health education and professional training programs, hospitals, health clinics, community health centers, medical and diagnostic laboratories, and health insurance issuers. All of the University’s Healthcare Components are considered covered entities and as such must comply with the provisions of Section 1557.

What procedural requirements must UW departments/units meet under Section 1557?

A. Notices of nondiscrimination and taglines
Initial and continuing steps must be taken to notify beneficiaries, enrollees, applicants, or members of the public of individuals’ rights under Section 1557 and of the covered entities’ nondiscrimination obligations with respect to their health programs and activities and to alert individuals with limited English proficiency to the availability of language assistance services through the use of taglines. The notices and taglines in significant publications and in significant communications must be placed in conspicuous physical and website locations. The taglines must be in at least the top 15 non-English languages spoken in the State in which the entity is located or does business.

B. Grievance Procedures
Covered entities are responsible for investigating any alleged actions prohibited by or in noncompliance with Section 1557. Grievance procedures that conform to the regulatory mandates must be adopted.

C. Designation of a responsible employee
At least one employee must be designated to coordinate compliance under Section 1557. Further, all employees essential to the department/unit’s compliance efforts are required to receive training regarding the department/unit’s Section 1557 policies and procedures.’]

When is the effective date for the implementation of Section 1557 provisions?

The effective date is July 18, 2016 with the exception of provisions with respect to posting notices of consumer rights and taglines (effective on October 18, 2016); accessibility standards for buildings not previously covered by the Americans with Disabilities Act; and design changes to health coverage (effective on the first day of the first plan year beginning on or after January 1, 2017).

Contacts for additional information

UW Medicine process and procedures:
Harborview Medical Center Patient Relations

UW Medical Center Patient Relations

University of Washington Clinics process and procedures:

Health Sciences Administration
Kelly Johnson, Assistant Director

School of Dentistry, Office of Clinical Services
Nga Wimbley-Dinh, Manager of Patient Relations

Research Programs process and procedures:

Research, Human Subjects Division
Karen Moe, Director & Assistant Vice Provost for Research