Agency Spotlight: U.S. Department of Health & Human Services

Agency Spotlight: U.S. Department of Health & Human Services





Greetings! I would like to share important updates from the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS). 

This newsletter edition marks the halfway point of the 2016 calendar year and we continue to see remarkable improvements in our nation’s health care system. The enactment of the Affordable Care Act (ACA) in 2010 set in motion a number of significant changes in the way our health care industry reaches and serves Americans.  The ACA has helped bring America’s uninsured rate to its lowest level on record; 20 million people have gained health insurance coverage because of the ACA, and, importantly, no one can be denied coverage because of pre-existing conditions.

The HHS OCR, in partnership with other agencies across HHS, has been taking steps to support the ACA’s goals of improving access to health care and coverage and reducing health disparities. Along those lines, OCR has been working to ensure the changes taking place protect vulnerable and underserved populations, and in some cases, extend protections for the first time in history! Read on to learn about transformative developments from HHS OCR.

                                    Jocelyn Samuels, Director of HHS Office for Civil Rights


HHS OCR Publishes a Final Rule Implementing Section 1557 of the ACA

Section 1557 is the nondiscrimination provision of the ACA stating that individuals cannot be subject to discrimination based on their race, color, national origin, sex, age or disability. The rule combines and harmonizes existing, well-established federal civil rights laws: 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. It makes historic gains by extending certain protections in the health care setting to vulnerable populations.

In May 2016, HHS OCR finalized the rule under Section 1557 ( to help ensure that every American has access to the health care they deserve. Section 1557 is aimed to advance equity and reduce health disparities by strengthening protections for some of the populations that have been most vulnerable to discrimination in the health care context.

Ensuring Meaningful Access for Individuals with Limited English Proficiency: Consistent with longstanding principles under civil rights laws, the final rule makes clear that the prohibition on national origin discrimination requires covered entities to take reasonable steps to provide meaningful access to each individual with limited English proficiency who is eligible to be served or likely to be encountered within the entities’ health programs and activities.

Specifically, Section 1557 requires covered entities to:

· Post a notice of individuals’ rights providing information about communication assistance for individuals with limited English proficiency, among other information; and,

· Post taglines in the top 15 languages spoken by individuals with limited English proficiency in that state to indicate the availability of language assistance.

While it is not a requirement under Section 1557, covered entities are also encouraged to develop and implement a language access plan to ensure they are prepared to take reasonable steps to provide meaningful access to each individual that may require assistance. To reduce the burden on covered entities, HHS OCR has translated a sample notice, a statement of nondiscrimination and taglines for use by covered entities in up to 64 languages. For translated materials, visit:

Protecting Individuals against Sex Discrimination: Section 1557 is the first federal civil rights law to explicitly prohibit sex discrimination in health care, including discrimination based on pregnancy, gender identity, and sex stereotyping. Notably, individuals must be treated consistent with their gender identity, including access to facilities; women must be treated equally with men in the health care they receive and the insurance they obtain; and categorical coverage exclusions or limitations for health care services related to gender transition are prohibited.

Ensuring Effective Communication with and Accessibility for Individuals with Disabilities: Section 1557 maintains existing standards by requiring covered entities to take appropriate steps to ensure that communications with individuals with disabilities are as effective as communication with others. The final rule also requires covered entities to make all programs and activities provided through electronic and information technology accessible and to ensure the physical accessibility of newly constructed or altered facilities.

Coverage of Health Insurance Plans on and off the Marketplaces: Section 1557 prohibits covered entities from discriminating on the basis of race, color, national origin, sex, age or disability when providing or administering health-related insurance or other health-related coverage. Covered entities cannot deny, cancel, limit, or refuse to issue or renew a health-related insurance policy or other health-related coverage or claim; impose additional cost sharing or other limitations or restrictions; or employ marketing practices or benefit designs that discriminate on any of these bases.

The final rule implementing Section 1557 applies to three types of entities: any health program or activity that receives funding administered by HHS; any health program that HHS itself administers; and the Health Insurance Marketplaces and issuers that participate in the Marketplaces.

Although the final rule on Section 1557 specifically applies only to HHS recipients of federal financial assistance, the statute makes clear that it applies to all health programs and activities, any part of which receives federal financial assistance from any federal agency. As a result, all federal agencies possess enforcement responsibility for programs they fund that are covered under Section 1557.

To learn more about Section 1557 and to download reading materials on the final rule, visit HHS OCR’s website at:

HHS OCR Issues Guidance for Long Term Care Facilities

HHS OCR has issued new guidance ( to assist long term care facilities in complying with their civil rights responsibilities and obligations under regulations by the HHS Centers for Medicare and Medicaid Services. In order to assess placement needs among residents, long term care facilities are mandated to routinely administer the Minimum Data Set (MDS) (, a standardized assessment tool for all residents in a Medicare and/or Medicaid-certified long term care facility. This guidance provides a series of recommendations for steps that long term care facilities can take to ensure the MDS is properly used to facilitate compliance with Section 504 and to avoid discriminatory practices towards residents.

To learn more about non-discrimination and health information privacy laws, civil rights, and privacy rights in health care and human service settings, and to find information on filing a complaint, visit us at Follow OCR on Twitter @HHSOCR.


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