On May 18, 2016, the U.S. Department of Health and Human Services (HHS) published a final rule implementing section 1557 of the Affordable Care Act (ACA).  The rule prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in any health program or activity that receives federal financial assistance. Among other requirements, the rule—which was generally effective on July 18, 2016—requires covered entities to post notices of nondiscrimination and taglines that alert individuals with limited English proficiency to the availability of language assistance services by October 16, 2016. 

Covered Entities

Section 1557 does not apply to all businesses and the final rule applies only to the following covered entities:

-Any health program or activity, any part of which receives funding from HHS (such as hospitals that accept Medicare or doctors who accept Medicaid);
-Any health program that HHS itself administers; and
-Health Insurance Marketplaces and issuers that participate in those Marketplaces.

These are the three different ways a business can be a covered entity. Two of the three ways are intended to pick up health insurance providers and health programs administered by HHS (e.g., Medicare and Medicaid).   The other category of covered entities is broadly defined to include any health program or activity that receives Federal financial assistance from HHS. 

Because of the limited types of entities covered by this final rule, most employers are exempted from the requirements of section 1557, including the notice and tagline requirements. 

Posting of Notice

The final rule generally requires each covered entity to post a notice stating that the covered entity:

-Does not discriminate on the basis of race, color, national origin, sex, age, or disability in its health programs and activities;
-Provides appropriate auxiliary aids and services, including qualified interpreters for individuals with disabilities and information in alternate formats, free of charge and in a timely manner (as well as how to obtain these aids and services); and
-Provides language assistance services, including translated documents and oral interpretation, free of charge and in a timely manner (as well as how to obtain these services).

The final rule requires each covered entity to post taglines in at least the top 15 non-English languages spoken in the State in which the entity is located or does business. Those requirements are modified for small sized significant communications such as postcards; for these, the final rule requires entities to post a nondiscrimination statement and taglines in at least the top two non-English languages spoken by individuals with limited English proficiency in the State.