Section 1557 of the ACA, and the Department’s implementing regulation, apply to:
- All health programs or activities that receive HHS funding;
- All health programs or activities administered by HHS itself (e.g., by the Centers for Medicare & Medicaid Services or the Substance Abuse and Mental Health Services Administration); and,
- The Health Insurance Marketplaces and plans offered by issuers that participate in those Marketplaces.
Who must comply with Section 1557?
Apr 10, 2019 · Section 1557 applies to any provider receiving federal financial assistance (“FFA”) from the Department of Health and Human Services (“HHS”) such as Medicaid and Medicare Parts A C and D as well as grants and credits from HHS such as meaningful use payments. Health insurers and group health plan sponsors must closely review the final rule titled …
Which providers accept United Healthcare Medicare plans?
Section 1557 is the nondiscrimination law in the Affordable Care Act (ACA). Section 1557 is important to achieving the ACA’s goals of expanding access to health care and coverage, eliminating barriers, and reducing health disparities. Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age, or disability
What do you need to know about Section 1557?
Section 1557 of the Affordable Care Act applies to a. all health programs and activities administered by or receiving federal financial assistance from HHS. b. Medicare Advantage plans only. c. all health programs and activities, public and private. d. health plans sold through the ACA Marketplaces only.
Which entity enforces Section 1557?
Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA). The law prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in health programs or activities that receive Federal financial assistance or are administered by an Executive agency or any entity established under Title I of the ACA.
Which Medicare program are covered by ACA Section 1557?
Medicare Advantage Plans Entities that receive reimbursement from an MA plan (including dental practices) must comply with Section 1557. Funds provided under the Medicare program (except for funds provided under Medicare Part B) constitute Federal financial assistance.
Who does Section 1557 of the ACA apply to?
The Section 1557 final rule applies to recipients of financial assistance from the Department of Health and Human Services (HHS), the Health Insurance Marketplaces and health programs administered by HHS.
What change did the Affordable Care Act make in Medicare?
The ACA closed the Medicare Part D coverage gap, or “doughnut hole,” helping to reduce prescription drug spending. It also increased Part B and D premiums for higher-income beneficiaries. The Bipartisan Budget Act (BBA) of 2018 modified both of these policies.Oct 29, 2020
Which of the following would be permissible under Section 1557 and the 2020 Final Rule?
The final Section 1557 rule allows health care providers and other covered entities to invoke blanket abortion and religious objection exemptions from the regulations' general prohibition on sex discrimination.Sep 18, 2020
Which of the following statements best describes Section 1557 of the ACA?
Which of the following statements best describes Section 1557 of the Affordable Care Act (ACA)? Section 1557 incorporates earlier civil rights protections in regard to race, color, national origin, disability, age and sex. Policies and procedures, physical access, and communication.
Does Section 1557 apply to self funded plans?
Under the 2020 rule, Section 1557 generally does not apply to self-funded group health plans under ERISA or short-term limited duration plans because the entities offering the plans are typically not principally engaged in the business of providing health care, nor do they receive federal financial assistance.
Does Medicare fall under the Affordable Care Act?
The federal government pays for most Medicare costs. Affordable Care Act (ACA) plans are usually offered by private health insurance companies. So, Medicare generally costs you less. Medicare, of course, is mainly for people 65 and over, although some people qualify through disability.Aug 6, 2021
Is Medicare Advantage Part of the Affordable Care Act?
The ACA does not eliminate Medicare Advantage plans or reduce the extra benefits they provide. It is up to each private insurer to decide what extra benefits to offer (they are required to offer all benefits covered by traditional Medicare).Jan 13, 2020
What is covered under the Affordable Care Act?
A set of 10 categories of services health insurance plans must cover under the Affordable Care Act. These include doctors' services, inpatient and outpatient hospital care, prescription drug coverage, pregnancy and childbirth, mental health services, and more. Some plans cover more services.
Which area of potential discrimination is not generally covered by ACA Section 1557 quizlet?
Loss of federal business and compensatory damages. Which area of potential discrimination is not generally covered by ACA Section 1557? Employment (with the exception of the provision of health insurance).
What are reasonable steps to provide meaningful access to each individual with LEP eligible to be served or likely to be encountered in
covered entity must take reasonable steps to provide meaningful access to each individual with LEP eligible to be served or likely to be encountered in its health programs and activities. Reasonable steps may include the provision of language assistance services, such as oral language assistance or written translations.
Why did multiple staff at a hospital create a hostile environment for a transgender woman?
Multiple staff at a hospital created a hostile environment for a transgender woman because she was transgender. She was also required to share a room with a male patient.
What is a covered entity?
covered entity must provide auxiliary aids and services to individuals with disabilities free of charge and in a timely manner when necessary to ensure an equal opportunity to participate and benefit from the entity’s health programs or activities.
Can a covered entity deny or limit benefits based on an individual's age?
Under Section 1557, a covered entity may not exclude, deny or limit benefits and services based on an individual’s age (e.g., a physician’s practice may not deny a 62-year-old man health services because it only accepts patients under age 60).
Did the hospital interpret LEP?
physician at a hospital’s emergency department denied a mother with LEP a Spanish interpreter when she requested language assistance. Instead, the physician used the mother’s 13- year-old son as the interpreter, while he was being treated for a dog bite. The hospital also failed to translate or orally explain the discharge instructions in Spanish.
Can a covered entity discriminate on the basis of race, color, national origin, sex, age,
Under Section 1557, covered entities may not , in providing or administering health-related insurance or other health-related coverage, discriminate on the basis of race, color, national origin, sex, age, or disability.
What is Section 1557?
Section 1557 imposes similar requirements on health insurance issuers that receive federal financial assistance. Health care providers and insurers are barred, among other things, from excluding or adversely treating an individual on any of these prohibited bases.
What is the 1557 rule?
Section 1557 makes it unlawful for any health care provider that receives funding from the Federal government to refuse to treat an individual – or to otherwise discriminate against the individual – based on race, color, national origin, sex, age or disability. Section 1557 imposes similar requirements on health insurance issuers that receive federal financial assistance. Health care providers and insurers are barred, among other things, from excluding or adversely treating an individual on any of these prohibited bases. The Section 1557 final rule applies to recipients of financial assistance from the Department of Health and Human Services (HHS), the Health Insurance Marketplaces and health programs administered by HHS.
What is the final rule of the ACA?
The final rule is consistent with existing, well-established Federal civil rights laws and clarifies the standards HHS will apply in implementing Section 1557 of the ACA. These standards provide that individuals cannot be denied access to health care or health coverage or otherwise be subject to discrimination because of race, color, national origin, sex, age, or disability.
How does OCR evaluate compliance?
OCR will evaluate an entity’s compliance by using a fact-dependent, contextualized analysis . OCR will give substantial weight to the nature and importance of the health program and the particular communication at issue. OCR will also consider other relevant factors, such as: (a) the length, complexity, and context of the communication; (b) the prevalence of the language in which the individual communicates among those eligible to be served or likely to be encountered; (c) the frequency with which a covered entity encounters the language in which the individual communicates; (d) all resources available to the covered entity; (e) the cost of language assistance services and whether a covered entity has availed itself of cost-saving opportunities; and (f) whether a covered entity has explored the individual’s preference, if any, for a type of language assistance service. OCR will also take into account whether the entity developed and implemented an effective, written language access plan.
What is the final rule of the Civil Rights Act?
The final rule builds on the standards of the four Federal civil rights laws referenced in Section 1557 and their implementing regulations: Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, and the Age Discrimination Act of 1975.
What is the Franciscan Alliance v Burwell case?
et al v. Burwell, enjoining the Section 1557 regulation’s prohibitions against discrimination on the basis of gender identity and termination of pregnancy on a nationwide basis.
When did OCR 1557 go into effect?
Section 1557 went into effect on March 23, 2010. [40]. The final regulation was published by the Department on May 18, 2016. [41]. The final regulation became effective on July 18, 2016, with the exception of provisions of the regulation that require changes to health insurance or group health plan benefit design, which apply as of the first day of the first plan year (or, in the individual market, policy year) beginning on or after January 1, 2017. [42] As noted in the preamble to the final rule, OCR recognizes that some covered entities will have to make changes to their health coverage to bring that coverage into compliance with the final rule; OCR is “sensitive to the difficulties that making changes in the middle of a plan year could pose for some covered entities and is committed to working with covered entities to ensure that they can comply with the final rule without causing excessive disruption for the current plan year.” [43]
What is a covered entity under Section 1557 of the ACA?
Under Section 1557 of the Affordable Care Act (Section 1557), “covered entities,” which were defined as health programs or activities that receive “federal funding” from the U.S. Department of Health and Human Services (HHS) cannot discriminate on the basis of race, color, national origin, disability, age or sex.
When was Section 1557 of the Affordable Care Act?
Section 1557 incorporates existing federal civil rights laws, including protections on the basis of sex under Title IX, and applies them to federally funded health programs. Section 1557 is one of the few parts of the ACA that went into effect upon enactment in 2010.
What are possible consequences of violation of ACA Section 1557?
Eligibility for coverage. As a result of violations of ACA Section 1557 nondiscrimination rules, a. health plans may be fined, but their agents and brokers are not affected.
Who enforces Section 1557 of the Affordable Care Act?
The Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (the Department) is responsible for enforcing Section 1557 of the Affordable Care Act (Section 1557) and regulations issued under Section 1557, protecting the civil rights of individuals who access or seek to access covered health …
What area of potential discrimination is not generally covered by ACA Section 1557?
Under Section 1557 of the Affordable Care Act (ACA), individuals may not be denied, cancelled, limited, or refused health coverage on the basis of race, color, national origin, sex, age, or disability.
What is HHS rule?
HHS enforces federal civil rights laws that protect the rights of individuals and entities from unlawful discrimination on the basis of race, color, national origin, disability, age, or sex in health and human services.
Does Section 1557 require language assistance?
While you may not be required to comply with Section 1557, providing language services is still worth considering: Limited-English speakers are among the fastest-growing segment of the U.S. population, and by providing language access to these individuals, your business could see massive growth.
