American Dental Association

Section 1557 of the Affordable Care Act


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      Acknowledgements

      The American Dental Association’s Department of Product Development and Sales developed this publication.

      Principal contributors to this manuscript were Kathryn Pulkrabek, Manager/Editor, Professional Products, Department of Product Development and Sales; Carolyn B. Tatar, M.B.A., Senior Manager, Department of Product Development and Sales; and the staff of the ADA Center for Professional SuccessTM.

      For more information on the ADA Center for Professional Success, visit Success.ADA.org.

      Disclaimer: Reproduction of this material by member dentists and their staff is permitted for their internal office use only. Any other use, duplication or distribution by any other party requires the prior written approval of the American Dental Association. This material is for general reference purposes only and does not constitute legal advice. It covers only federal law but not state law. Changes in applicable laws or regulations may require revision. Dentists should contact qualified legal counsel for legal advice, including advice pertaining to Section 1557 of the Affordable Care Act, the U.S. Department of Health and Human Services final rule and/or the enforcement of Section 1557 by the Office for Civil Rights. To the extent we have included links to any website, we intend no endorsement of their content and imply no affiliation with the organizations that provide their content. Nor do we make any representations or warranties about the information provided on those sites, which we do not control in any way.

      © 2017 American Dental Association. All Rights Reserved.

      Table of Contents

       Introduction

       Chapter 1: The Basics of Section 1557

       Covered Dentists and Dental Practices

       Effective Dates

       Posting Notices and Taglines

       Taglines

       Chapter 2: Individuals with Limited English Proficiency (LEP)

       Assessing an Individual’s Need for Language Assistance

       Computer-Automated Translation

       In-Person and Remote Interpretation

       No Coercion or Discouragement

       Adults Who Accompany the Individual

       Minor Children

       Translations of Written Documents

       HIPAA Business Associate

       Qualified Interpreters and Translators

       Qualified Interpreters for Individuals with LEP

       Qualified Translators for Individuals with LEP

       Chapter 3: Individuals with Disabilities

       Qualified Interpreters for Individuals with Disabilities

       Auxiliary Aids and Services for Effective Communication

       Examples of Other Requirements Pertaining to Individuals with Disabilities

       Accessibility of Electronic and Information Technology

       Chapter 4: Other Types of Discrimination

       Sex Discrimination

       Discrimination Based on Sexual Orientation

       Age Discrimination

       Chapter 5: Grievance Procedures

       Chapter 6: Employee Health Programs

       Chapter 7: Section 1557 Final Rule Checklist

       Appendices

       Appendix A: Sample Notice of Nondiscrimination for Covered Dental Practices with 15 or More Employees

       Appendix B: Sample Notice of Nondiscrimination for Offices with Fewer Than 15 Employees

       Appendix C: Sample Shortened Notice of Nondiscrimination for Small-Sized Significant Publications and Communications

       Appendix D: Sample Tagline

       Appendix E: Sample Contract and Business Associate Agreement for Interpreters and Translators

       Appendix F: Sample Language Access Plan

       Appendix G: Sample Grievance Procedure

      Introduction

      Section 1557 of the Affordable Care Act protects individuals from discrimination on the basis of race, color, national origin, age, disability, and sex in federally funded health-related services and coverage. On May 18, 2016, the U.S. Department of Health and Human Services (HHS) published a final rule under Section 1557. The final rule, which applies to dentists and dental practices that receive certain kinds of funds from HHS, is enforced by the Office for Civil Rights (OCR), the federal agency that enforces HIPAA. More information on the final rule is available on the OCR website at www.hhs.gov/civil-rights/for-individuals/section-1557/index.html. A link to the final rule itself is available at www.federalregister.gov/documents/2016/05/18/2016-11458/nondiscrimination-in-health-programs-and-activities.

      Dental practices may already be subject to many of the Section 1557 requirements and prohibitions through other applicable federal,