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ACA's Nondiscrimination Policy Applies to Medi-Cal

August 4, 2017

Section 1557 of Patient Protection and Affordable Care Act (ACA) prohibits discrimination on the basis of race, color, national origin, sex, age or disability in certain health programs or activities. In effect since 2010, Section 1557 builds on long-standing 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.

Effective July 18, 2016, the Health and Human Services (HHS) Office for Civil Rights issued its final rule implementing Section 1557 at Title 45 Code of Federal Regulations (CFR) Part 92. The rule applies to any health program or activity, any part of which receives federal financial assistance, an entity established under Title I of the ACA that administers a health program or activity, and HHS. In addition to other requirements, Title 45 CFR Part 92.201, requires:

  • Language assistance services requirements
    Language assistance services required under paragraph (a) of Part 92.201 must be accurate, timely and provided free of charge, and protect the privacy and independence of the individual with limited English proficiency
  • Specific requirements for interpreter and translation services
    Subject to paragraph (a) of Part 92.201:
    • A covered entity shall offer a qualified interpreter to an individual with limited English proficiency when oral interpretation is a reasonable step to provide meaningful access for that individual with limited English proficiency
    • A covered entity shall use a qualified translator when translating written content in paper or electronic form

For more information about the application and requirements of the final rule implementing Section 1557, providers should contact their representative professional organizations. They may also visit the Section 1557 of the Patient Protection and Affordable Care Act page of the HHS website to find sample materials and other resources.