Frequently Asked Questions

Frequently Asked Questions




What qualifies as "Federal financial assistance" for purposes of civil rights complaints handled by the Department of Health and Human Services Office for Civil Rights?


The following is a nonexhaustive list of examples of recipients of federal financial assistance from the U.S. Department of Health and Human Services Office for Civil Rights (HHS OCR): Health care providers participating in the Children’s Health Insurance Program (CHIP) and Medicaid programs; hospitals and nursing homes (recipients under Medicare Part A); certain Medicare Advantage Plans (e.g., HMOs and PPOs) (recipients under Medicare Part C); Prescription Drug Plan sponsors and Medicare Advantage Drug Plans (recipients under Medicare Part D); grantees. As recipients of federal financial assistance, these entities are subject to the nondiscrimination requirements under Title VI and its implementing regulations.

Must Medicaid, CHIP and Medicare Part A providers, and organizations offering Medicare Part C and Part D plans, provide interpreters for LEP beneficiaries and translate their documents into languages other than English?


Under Title VI and its implementing regulations, recipients of federal financial assistance must take reasonable steps to ensure meaningful access to their programs, services, and activities by eligible LEP persons. To comply with these federal requirements, Medicaid and CHIP providers, Medicare Part A providers, and organizations offering Medicare Part C and Part D Medicare Advantage Plans and Prescription Drug Plans, for example, may need to provide language assistance services, such as interpreters and translated documents. Such services should be provided free of charge and in a timely manner. Also, for markets with a significant non-English speaking population, Medicare regulations for the Medicare Advantage Program and Voluntary Medicare Prescription Drug Benefit program require recipients to provide materials in the language of these individuals. See 42.C.F.R. 422.2264(e) and 423.2264(e). Recipients are encouraged to implement language access plans.

May recipient hospitals and nursing homes take into account the racial preferences of patients or residents with regards to staff and room assignments?


No. HHS OCR’s longstanding “Guidelines for Compliance of Hospitals with Title VI of the Civil Rights Act of 1964,” make clear that assignment of hospital staff or patient rooms based on the racial preference of the patient violates Title VI. Hospitals and nursing homes are similarly prohibited from honoring patient requests for room transfers based on race. HHS OCR referenced this longstanding guidance in two resolution agreements executed in 2015. See Hurley Agreement ( and  Shiawassee Resolution Agreement (

Does Title VI apply to hospital closures and relocations?


Yes. Hospital relocations and closures are sometimes challenged on the grounds that they will force residents of predominantly minority neighborhoods to travel greater distances for service, without an attempt to demonstrate that this would cause a hardship or that the quality of service and care would be diminished. For example, in 2010 HHS OCR investigated a complaint against the University of Pittsburgh Medical Center (UPMC), which alleged the intended closure of UPMC’s Braddock Hospital in Braddock, Pennsylvania would have a disparate impact on African-Americans. HHS OCR and UPMC reached a voluntary resolution in which UPMC agreed to provide a range of services. See voluntary resolution agreement (

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