Section 1557 of the Affordable Care Act- 3 important things to know

Regulations and rules- Section 1557

Section 1557 of the Affordable Care Act

So what is Section 1557 of the Affordable Care Act (ACA)?

Section 1557 is the nondiscrimination provision of the ACA. This piece of legislation prohibits discrimination based on race, color, national origin, sex, age, or disability in particular health programs:

  • that receive funding from the Health and Human Services,
  • which HHS itself administers
  • or Health Insurance Marketplaces and all plans offered by issuers that participate in those m Marketplaces.

Health and Human Services (HHS) published its final proposed rule implementing the anti-discrimination provisions of the Affordable Care Act (ACA), which includes regulations for serving Limited English Proficient (LEP) patients. This proposed rule is intended to advance health equity and reduce disparities in health care.

Here are 3 important things to know about Section 1557

1. Covered entities are required to post a notice in the top 15 languages spoken by LEPs statewide, indicating that communication assistance is available.

(A covered entity is any entity that operates a health program or activity that receives federal financial assistance under programs operated by HHS.)¹
The top 15 languages spoken by LEPs in the US are:
  • Spanish
  • Korean
  • Arabic
  • Portuguese
  • Italian

.

  • Chinese
  • Tagalog
  • French Creole
  • Polish
  • German

.

  • Vietnamese
  • Russian
  • French
  • Japanese
  • Farsi

Don’t have access to those notices?

We have you covered. Visit our Client Language Resource page, where you can download our:

Both documents can help an LEP identify their language so you can request an interpreter.

In addition to the multilingual taglines, the legislation also asks for the posting of nondiscrimination statements.

Deaf and Hard of Hearing patients are also covered under the proposed rule, as it requires covered entities to provide effective communication by providing access to auxiliary aids and services, including alternative formats and sign language interpreters. Covered entities must post information about these services as well.

2. Covered entities may use machine translation for written documents and websites, but post-translation review by a ‘qualified’ translator is REQUIRED.

  • HHS rejected insistence by some to ban machine translation because “such a requirement may unintentionally stifle innovation in this rapidly developing area.”²
  • HHS also asserts that “depending on the language at issue as well as the content of the translation, some translation technologies are advantageous to facilitate the translation of written content when used along with a qualified translator who independently verifies the accuracy and quality of the translation,” such as translation memory software.³
  • The requirement to have a qualified translator review the machine translations could check hospitals’ prior use of MT without quality control. No prior law or directive has prohibited it in the past.

3. Section 1557 of the ACA “harmonizes protections provided by existing, well-established federal civil rights laws.” These are:

Covered entities “must ensure compliance with existing laws in addition to the new ACA rules, including state laws that may be more restrictive than the ACA regulations.”

  1. Kim C. Stanger. “New ACA Anti-Discrimination Rules: Language Assistance for Non-English Speakers.” May 26, 2016. www.lexicology.com. Accessed May 2016.
  2. Sylvia Burwell. “Nondiscrimination in Health Programs and Activities.” May 11, 2016. www.federalregister.gov. Accessed May 2016.
  3. Sylvia Burwell. “Nondiscrimination in Health Programs and Activities.”
  4. U.S. Department of Healthy & Human Services: Office for Civil Rights. “Nondiscrimination in Health Programs and Activities Proposed Rule: Section 1557 of the Affordable Care Act.” www.hhs.gov. Accessed May 2016.
  5. Kim C. Stanger. “New ACA Anti-Discrimination Rules: Language Assistance for Non-English Speakers.”

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