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The U.S. Department of Health and Human Services (HHS) issued its final rule expanding nondiscrimination requirements. The 99-page rule, which goes into effect on July 18, implements Section 1557 of the Affordable Care Act (ACA), prohibiting discrimination of patients on the basis of sexual orientation or gender identity. The rule also enhances language assistance for patients with limited English proficiency (LEP).
Patient discrimination is already prohibited on the basis of race, color, national origin, sex, age, or disability in certain health programs and activities. The final rule applies to any health program or organization that accepts Medicare and Medicaid patients. Among other provisions, transgender patients will be permitted to enter a hospital ward or restroom consistent with the patient’s gender identity.
In addition to sex discrimination protections, the rule also provides greater assistance to patients with LEP. Interpreters must be provided for critical communications, and key documents can be translated into the patient’s native language. Hospitals and covered entities are required to post notices about communication and language assistance. Insurers who provide coverage through Healthcare.gov are also required to comply with the rule.
It is estimated that training and administrative costs for state and federal agencies will be $960 million dollars. Hospitals should have legal counsel and administrative review this rule carefully.
Summary and fact sheets are available at the Office of Civil Rights website.