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ACA Non-Discrimination Provisions Take Effect

Please see the update below from NARHC on provisions of the Affordable Care Act relating to individuals with Limited English Proficiency and how these requirements impact RHCs.

On October 16, Section 1557 of the Affordable Care Act goes into effect. This section is designed to provide meaningful access to individuals with Limited English Proficiency (LEP) among other things. Those affected by the provisions include all physicians receiving financial assistance from HHS (except solely Medicare Part B). According to the final rule, rural health clinics are considered covered entities and will need to comply with the provisions.

In general, RHCs must post taglines and notices concerning the availability of language assistance for non-English speaking individuals. A tagline is a “short statement written in non-English informing individuals that language assistance services are available free of charge.” The taglines must be posted in the 15 most spoken languages in each state; a list of most spoken languages was published by CMS here.

Section 1557 is intended to prevent any health programs that receive federal money from discriminating on the basis of race, color, national origin, sex, age, or disability. The rules require no-cost language assistance for individuals with LEP. The rules also specify how written and oral communication must be interpreted; stating that a “qualified translator” must be used when translating written content and oral interpretation must be provided when it is a reasonable step to provide meaningful access. Section 1557 also requires that if the covered entity has 15 or more employees, there must be an employee designated to handle 1557 compliance and grievance procedures.

Besides its protections for individuals with LEP, the section also: extends protections against sex discrimination, incorporates laws that aim to prevent disability-based discrimination, and prohibits discriminatory health insurance benefit designs.

HHS has provided the following resources to assist with compliance:

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