3 Deadlines Healthcare Entities Must Meet under Section 1557 in 2025
On May 6, 2024, the U.S. Department of Health and Human Services (HHS) published its Final Rule implementing the antidiscrimination provisions under Section 1557 of the Affordable Care Act (ACA). Section 1557 prohibits discrimination on the basis of race, color, national origin, age, disability, or sex in covered health programs or activities.
If legalese isn’t your thing but you’d like to take a deeper dive into what’s in the Final Rule on Section 1557, you can download our Section 1557 Cheat Sheet that breaks down the updated regulations for you. The regulations cover the provision of interpreter services and auxiliary aids, the delivery of telehealth services, direction on machine translation and ad hoc interpreters, and more.
When did the Final Rule take effect?
Many of the Final Rule requirements became effective on or soon after July 5, 2024. For example, November 2, 2024, was the deadline for two notable milestones:
- Covered entities with 15 or more employees must appoint a Section 1557 coordinator to oversee their efforts to comply with and carry out their responsibilities under Section 1557; and
- All covered entities must provide and visibly post a notice of nondiscrimination to participants, beneficiaries, enrollees, and applicants of its health programs and activities, and to members of the public.
Other Final Rule requirements, including 3 important milestones related to language access, have upcoming 2025 deadlines you’ll want to keep on your radar.
1. Training on Language Access Policies & Procedures
Deadline: Within 30 days of implementing required policies and procedures (but no later than May 1, 2025)
What needs to happen: A covered entity must train relevant employees on their organization’s language access and effective communication policies and procedures.
Requirements for this training include:
- Training must take place no later than 30 days after a covered entity implements their policies and procedures;
- Relevant employees must be trained on any notable changes to the policies and procedures;
- After the initial training, new relevant employees must be trained on policies and procedures in a reasonable amount of time; and
- All training must be documented.
2. Mitigating Risk with Patient Care Decision Support Tools
Deadline: May 1, 2025
What needs to happen: Covered entities must use patient care decision support tools in a nondiscriminatory manner.
Patient care decision support tools include any automated or non-automated tool, mechanism, method, or technology, including the use of artificial intelligence or clinical algorithms.
Essentially, this prevents covered entities from using algorithms, devices, or tools in a way that results in discrimination on the basis of race, color, national origin, sex, age, or disability.
Beyond the May 1 deadline, covered entities will have an ongoing responsibility to identify their use of patient care decision support tools that directly measure race, color, national origin, sex, age, or disability. They also must make reasonable efforts to mitigate the risk of discrimination or bias from their use of these tools.
While this requirement doesn’t mandate the provision of language access services, implicit bias in design or the lack of data from a diverse patient population, for example, could directly impact decisions around patient care for limited English proficient individuals.
Free Download: CLI’s Section 1557 Cheat Sheet
3. Notices and Implementation of Language Access Policies & Procedures
Deadline: July 5, 2025
What needs to happen: This deadline covers a host of requirements related to language access covered below.
Post Notice of Availability of Language Assistance Services and Auxiliary Aids and Services: Covered entities must provide a notice that they provide language assistance and auxiliary aids and services free of charge.
This notice must:
- Be available in English and (at minimum) in the top 15 spoken languages spoken in the covered entity’s state;
- Be posted on the entity’s website in a conspicuous location;
- Be posted in clear, prominent physical locations, in no smaller than 20-point sans serif font, where individuals seeking service from the health program or activity can reasonably be expected to read or hear the notice; and
- Be provided in alternate formats for individuals with disabilities who require auxiliary aids and services to ensure effective communication.
Tip: The Office for Civil Rights provides translated sample notices (as well as sample policies and procedures) that a covered entity can tailor for its use.
See also: The Language Access Materials You Need to Know About
Adopt and Implement Policies and Procedures: A covered entity must implement written policies and procedures to include:
- A nondiscrimination policy with current contact information for the Section 1557 coordinator, stating that the covered entity:
- Does not discriminate;
- Provides language assistance services and auxiliary aids free of charge; and
- Provides reasonable modifications for individuals with disabilities.
- A grievance procedure that provides for the prompt and equitable resolution of grievances related to Section 1557 (applies to entities with 15 or more employees).
- Records of grievances must be kept for 3 years.
- A covered entity must keep the identity of an individual who has filed a grievance confidential.
- A language access procedure that describes the covered entity’s process for providing language assistance. It must include:
- Current contact information for the Section 1557 coordinator;
- How an employee identifies an individual with LEP;
- How an employee obtains the services of qualified interpreters and translators;
- The names of any qualified bilingual staff members; and
- A list of any electronic and written translated materials the covered entity has, the languages they are translated into, the date of issuance, and how to access electronic translations.
- Effective communication procedures that describe the covered entity’s process for ensuring effective communication for individuals with disabilities. It must include:
- Current contact information for the Section 1557 coordinator;
- How an employee obtains the services of qualified interpreters, including the names of any qualified interpreter staff members; and
- How to access appropriate auxiliary aids and services, at no cost to individuals with disabilities.
- Reasonable modification procedures that outline the covered entity’s process for making reasonable modifications to its policies, practices, or procedures when necessary to avoid discrimination. It must include:
- Current contact information for the Section 1557 coordinator;
- A description of how to handle requests from individuals with disabilities for changes, exceptions, or adjustments to a rule, policy, practice, or service; and
- A process to decide if making the change would significantly alter the health program or activity, and finding an alternative change that doesn’t cause a major change, to ensure the individual with a disability still gets the benefits or services.
Related: How to Create a Realistic Language Access Plan
Looking Ahead to Enhanced Language Access in 2025
One thing is clear from Section 1557’s Final Rule: The future of language access looks bright in 2025. At their core, these regulations are aimed at preventing discrimination against individuals with limited English proficiency and disabilities.
That’s no small thing. The more protections that are in place to ensure effective communication and equitable access, the better for the health and well-being of our diverse communities across the country.
If your organization hasn’t already started gearing up to meet the upcoming deadlines, now’s the time. And you don’t have to go it alone. CLI offers our clients free language access training services, guidance, materials, and resources to help make sure they’re in compliance with Section 1557.
If you want to learn more about how we can help your organization maintain compliance with Section 1557, please get in touch with us.
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