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LAST UPDATED: May 2024 

First introduced in 2010, Section 1557 of the Affordable Care Act prohibits discrimination based on age, sex, disability, race, color, and national origin, which includes the language an individual speaks.

Recent changes to Section 1557 have further strengthened these protections, particularly about language access in healthcare. The enhancement of language assistance services for individuals with limited English proficiency (those whose primary language is not English or speak English less than "very well”) is just one piece of the puzzle in the law's efforts to reduce disparities in healthcare.

To help make sense of the update to the law, we’re breaking down exactly who the law affects, who is subject to section 1557, and how those affected can get into compliance with section 1557 language access requirements, with two simple flowcharts:

 

Do I need to comply with Section 1557 of the Affordable Care Act (ACA)?

Are you a health program or activity that:

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 Receives Federal financial assistance from the Department of Health and Human Services (HHS)?
Health programs and activities include health care providers (such as hospitals, health clinics, physicians’ practices, community health centers, mental health centers, nursing homes, and rehabilitation facilities), health plans, and health insurers. 

Federal financial assistance includes grants, tax credits, property, Medicaid, and Medicare Part A, B, C, and D payments.
LingoAsset-png-1 Is administered by entities created under Title I of the ACA?
Examples of entities created under Title I of the ACA include the State-based and Federally-facilitated health insurance marketplaces.
LingoAsset-png-1 Is administered by HHS?
Health programs and activities administered by HHS include Medicare and the Federally-facilitated health insurance marketplaces. 

 

If you answered "Yes" to any of the questions above:

You must comply with and implement Section 1557 of the Affordable Care Act. Continue reading to find out what you need to ensure compliance with the language assistance requirements of Section 1557.

 

 

If you answered "No" to all of the questions above:

While you may not be required to comply with Section 1557, providing language services is still worth considering: Limited English speakers and speakers of non-English languages are among the fastest-growing segments of the U.S. population, and by providing language access to these individuals, your business could see massive growth.

 

 

Am I compliant with the language access requirements of Section 1557?

Do you currently offer:

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Interpretation and written translation services?
To ensure limited-English-speaking, Deaf, and hard of hearing patients have "meaningful access" to care and coverage, entities covered by section 1557 must offer language assistance, such as interpreting and translation services, at no cost to the individual and in a timely manner. If needed, language access services should be provided to patient companions.

These services are provided by qualified interpreters, translators, and bilingual staff. 

Reliable, high-quality video technology must be provided when using video remote interpreting services to communicate with individuals with limited English proficiency.

Additionally, if machine translation is being used for important patient communication, a qualified human translator must review the translated content. 

 
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Translated notices of availability of language assistance services?
Covered entities must post notices of available language assistance and services in English and the top 15 languages spoken in the state in which the entity is located or does business. These notices must accompany notices of anti-discrimination and should be prominently displayed in physical locations, available on the entity's website upon request, and accompany important communications.
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Easy access to telehealth services? 

Organizations must ensure all telehealth services are easily accessible to all individuals with limited English proficiency and those with disabilities. 
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 Documented Section 1557 policies and procedure

Under the Final Rule, organizations should document Section 1557 policies and procedures, conduct staff training on the policies and procedures, and reinstate a Section 1557 coordinator to ensure compliance. 

 

If you answered "Yes" to all of the questions above:

You are on the right track - you've implemented the most vital requirements of the language assistance provisions of Section 1557!  But, be sure your organization understands the specifics behind the language access requirements to ensure you're fully compliant when the 2024 Final Rule goes into effect on July 5, 2024. 

 

If you answered "No" to any of the questions above:

You have a compliance issue. All covered entities are required to offer language assistance services, such as oral interpretation and written translation. 

 

 

 

Ready to Ensure Your Organization Stays in Compliance? 

Download our FREE Section 1557 Compliance Checklist.

 
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No Legal Advice and Disclaimer to Accuracy of Information

The information in this webpage is for informational purposes only, and is not legal advice, regulatory advice, and/or a substitute for legal and/or other expert counsel.  The information on this page is not guaranteed to be correct, complete, or most current, and should not be relied upon as such. Nothing on this page should be used as a substitute for the advice of competent legal counsel.