Heyl Royster

Section 1557 Healthcare Nondiscrimination Deadline this Week

october 12, 2016

By: Deanna Mool

On top of billing issues, HIPAA audits, and other compliance and regulatory issues relating to the delivery of services, healthcare facilities are also facing an October 16th deadline for Section 1557 compliance. Section 1557 is the non-discrimination provision of the Accountable Care Act (Obamacare). HHS issued final regulations in July 2016, and the remainder of the provisions of those regulations become active this week. The “Nondiscrimination in Health Program and Activities,” 45 CFR part 92, affects all entities that are defined as “covered entities.” However, the definitions of “covered entity” under HIPAA versus Section 1557 are very different. Section 1557 is focused on entities that receive federal financial assistance for healthcare. Federal financial assistance is provided through grants, federal personnel, discounted or free use of federal property, discount leases, and those who administer the federal and state health insurance marketplaces. Some examples of entities that receive federal financial assistance include: any provider accepting Medicare or Medicaid, hospitals, rural health clinics, federally qualified health centers, health insurance programs, state Medicaid agencies, community health centers, physician practices, home healthcare agencies, and the Health Insurance Marketplaces—both state and federal.

Section 1557 and its regulations prohibit discrimination in healthcare due to race, color, national origin, sex, age, or disability. If your facility is a covered entity under Section 1557 and you have more than 15 employees, you will need to designate an employee responsible to take grievances that Section 1557 rights have been violated. You will also have to adopt grievance procedures to address allegations that Section 1557 has been violated.

Finally, all Section 1557 covered entities must provide meaningful access to health care for individuals with limited English proficiency. These requirements are fairly detailed and require careful planning by the covered entity. In general, you cannot require an individual to provide their own interpreter and the language assistance must be free and by a qualified interpreter.

No later than October 16, 2016, all covered entities must provide notice of the fact that they do not discriminate in any of the above-listed categories in their healthcare programs and activities. This notice can be provided by using all of the following methods: posting it in conspicuous physician locations (your lobby), on the website (accessible from the home page) and in significant publications. The entity must also post a “tagline” in the top 15 languages spoken by individuals with limited English proficiency in Illinois in the same locations. The rule also contains requirements for taglines for the top two languages spoken in the State to be present on small sized postcards or trifold brochures of the covered entity.

Federal regulators have provided a standard notice and taglines in the various languages on the HHS website. This website also contains links to the top 15 languages in Illinois and other helpful materials. The HHS website is: https://www.hhs.gov/civil-rights/for-individuals/section-1557/index.html. Our clients have noticed that the top 15 languages in Illinois may not be the top 15 languages spoken by your patients. However, the regulatory requirements relate to the languages listed by HHS as the top 15 in the State.

Section 1557 entities still need to assure they have proper polices and grievance procedures in place. You may call any of our healthcare attorneys to receive review of your policies or assistance with compliance.

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