In part two of our three-part educational series on Section 1557, the non-discrimination provision of the Affordable Care Act (ACA), we explored key updates to the regulation and offered actionable guidance to help organizations prepare for compliance. We focused on areas of operational complexity, including timelines, regulatory changes, and best practices to ensure that responsibilities are met. 

This article will help you navigate the three major requirements from the final ruling of Section 1557 covered in our second educational session. 

What You Need to Know About Section 1557

A Quick Recap of Section 1557 

Section 1557 of the Affordable Care Acts prohibits discrimination on the grounds of race, color, national origin, sex, age, or disability in any health program or activity receiving federal financial assistance. This provision emphasizes equity and meaningful access to healthcare services for all.

Recent updates focus on the importance of language access, effective communication, and anti-discrimination in emerging healthcare technologies such as telehealth and AI. 

For organizations, this means tackling new standards while maintaining compliance with long-standing federal regulations like the Civil Rights Act, the Rehabilitation Act, and the Americans with Disabilities Act (ADA). 

See Also

Webinar Recap Part 1: Affordable Care Act – Section 1557

3 Key Deadlines You Should Know 

Understanding and adhering to regulatory deadlines is crucial. Here are the top deadlines associated with Section 1557 compliance requirements: 

1. Language Assistance Availability Notices 

• Due Date: July 5, 2025
• Organizations must post notices in the top 15 languages of their state, following specific formatting requirements, including a minimum font size of 20. These notices must also be prominently published on websites and included in critical documents like benefits notices and discharge summaries. 

2. Written Language Access Procedures 

• Due Date: July 5, 2025
• Covered entities must develop comprehensive, written policies detailing how they provide language access services, including steps for identifying needs, offering qualified interpreters, and maintaining translated materials for top languages. 

3. Non-Discrimination in the Use of Patient Care Decision Tools (AI) 

• Due Date: On-Going 
• From the moment the final ruling of Section 1557 was enacted into law (May 2024) organizations must identify and mitigate potential discrimination risks in AI-driven decision-making tools. This involves ongoing monitoring and ensuring compliance with input variables related to race, sex, disability, and other protected categories. 

Preparing Your Organization for Compliance 

Here’s how your organization can prepare for compliance with the upcoming deadlines.

1. Conduct a Compliance Gap Analysis 

Review your current policies, language access practices, and use of patient-facing technologies. Are there gaps that could pose compliance risks? Conducting a thorough analysis is the first step in creating a roadmap for improvement. 

2. Update Policies with Written Language Access Procedures 

Ensure your policies align with the mandated standards. These should detail how your organization handles non-discrimination, including processes for obtaining and using qualified interpreters and translators. 

3. Enhance Implementation of Technology Policies 

AI-based healthcare tools are rapidly evolving, but this comes with inherent risks. Develop AI governance committees to oversee implementation and ongoing monitoring. These committees should include legal, compliance, and clinical leaders.

4. Deploy Accessible Tools for Telehealth 

To meet telehealth non-discrimination requirements, ensure your platforms include built-in accessibility features such as screen reader compatibility, real-time captioning, and remote interpreting capabilities. Train healthcare providers on these tools to remove barriers and improve patient satisfaction. 

5. Invest in Staff Training and Awareness 

Educate your staff on regulatory requirements, the importance of language access, and ethical considerations in AI and telehealth use. Training must be conducted within 30 days of any regulatory process updates. 

Section 1557 in Action: Operational Best Practices 

Language Access at Every Touchpoint 

Magnets for Interpretation Needs 

Attach small interpreter identification magnets to patient room door frames. These simple indicators alert staff of a patient’s need for language assistance.

Centralized Translation Repository 

Maintain a digital repository of translated documents for easy staff access. Include language identification in footers and provide the date of issue or update.

Dual Handsets and Devices 

Equip LEP (Limited English Proficient) patients’ rooms with dual-handset speakerphones or video remote interpreting devices, providing real-time access to interpreters. 

Effective Implementation of AI Tools 

When integrating decision-making tools into your organization, follow these practices to minimize discrimination and bias risks: 

• Perform due diligence during the acquisition stage, reviewing product documentation and academic literature.
• Develop clear policies for the use of AI tools, including routine validation and real-time monitoring for discriminatory outputs.
• Assemble interdisciplinary AI governance committees involving legal, compliance, and safety officers.

Driving Success in an Evolving Landscape 

Ongoing compliance with Section 1557 is an opportunity for your organization to lead with equity and innovation in healthcare delivery. By proactively addressing challenges, enhancing communication, and implementing safeguards against discrimination, you can provide better care for diverse populations, while reducing the risk of legal implications and patient dissatisfaction.

To learn more about how AMN Healthcare can support your compliance strategy and operational readiness, or to join our final webinar session for further insights, contact us today.

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