Complying with ACA’s Nondiscrimination Requirements

Section 1557 of the Affordable Care Act (ACA) requires covered entities to take certain actions to ensure they comply with their duty not to discriminate on the basis of race, color, national origin, sex, age, or disability in certain health programs and activities. Section 92.7 of the ACA final rule specifies two things entities must do to meet their non-discrimination obligations:

• Section 92.7(a) requires designation of an employee responsible for carrying out Section 1557 compliance efforts (which, for simplicity’s sake, we will refer to as “1557 coordinator”); and

• Section 92.7(b) requires the establishment of a grievance procedure to ensure fast and fair resolution of grievances under Section 1557.

Section 92.7(a) of the final rule says that the 1557 coordinator must be an employee but does not specify the kind of employee he/she must be or position he/she must hold. In fact, in its comments to the final rule, the Dept. of Health and Human Services Office of Civil Rights (OCR) confirms that the rule “does not prescribe” who within the entity may serve as 1557 coordinator. The OCR also says that it is okay to combine the coordinator’s function with other related duties, e.g., the person in charge of your civil rights compliance under Section 504 of the Americans with Disabilities Act can serve as 1557 coordinator, “as long as there is no conflict of interest.”

Note that you may not have to designate a 1557 coordinator at all if your lab or pathology practice is really small. The 1557 coordinator requirement applies only to covered entities that employ 15 or more persons.

For further discussion of how to comply with these ACA requirements, and model tools you can use, see the October issue of G2 Compliance Advisor.