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Section 1557 Overview

Regulations and Guidelines binders

On May 18, 2016, the U.S. Department of Health and Human Services published a final rule under Section 1557 of the Affordable Care Act to protect individuals from discrimination in health care on the basis of race, color, national origin, age, disability, and sex, including discrimination based on pregnancy, gender identity, and sex stereotyping. Section 1557 is enforced by the Office for Civil Rights, the federal agency that enforces HIPAA.

A dental practice is covered by the Section 1557 final rule if it receives certain kinds of government funds, such as reimbursement under Medicaid, or CHIP, or “meaningful use” payments. In addition, the government has taken the position that final rule applies to a dental practice that receives reimbursement under Medicare Advantage (Medicare Part C), whether the plan reimburses the dentist or the patient.

The effective date of the final rule is July 18, 2016, except for certain notice provisions, which take effect 90 days later. In addition to government enforcement, the Section 1557 final rule permits an individual or entity to bring a civil action to challenge a violation in a U.S. District Court.

The ADA Center for Professional Success has developed several member resources that answer questions about this new rule and what it means for your practice.