Maintaining compliance with Section 1557 of the Affordable Care Act can seem complex, but with proper understanding and guidance, upholding the requirements can be simplified. During the first session of a three-part webinar series, experts broke down key insights, important compliance deadlines, and best practices to help healthcare providers and administrators ensure compliance. This article summarizes the critical points from this session to help you understand what’s ahead and how your organization can prepare.

What is Section 1557? 

Section 1557 is the nondiscrimination provision under the Affordable Care Act, prohibiting discrimination in federally funded health programs based on criteria such as race, color, national origin, sex, age, and disability. It integrates civil rights protections from several pre-existing statutes, including Title VI, Title IX, Section 504, and the Age Discrimination Act, into the healthcare space.

While Section 1557 isn’t new, its scope and enforcement mechanisms have been evolving under recent regulations, particularly with updated requirements under the Biden administration. 

Key Historical Context 

• Impact of Title VI (1964): Title VI desegregated the healthcare industry overnight by prohibiting race-based discrimination in federally funded programs. Section 1557 builds upon this foundation.
• Language Access and Disparate Impact (1974–2000s): Legal cases and federal guidance established the principle that failing to provide meaningful language access can constitute national origin discrimination. 

Section 1557 Updates

The latest updates to Section 1557 have added new rules and reinstated prior requirements, with notable changes including: 

1. Expanded Protections: 

Discrimination based on sexual orientation and gender identity is explicit, though federal enforcement is currently limited due to ongoing court injunctions.

2.  AI Governance:

Healthcare organizations must identify the uses of Artificial Intelligence (AI) that could risk discriminatory outcomes and take ongoing steps to mitigate those risks. 

3.  Medicare Part B Inclusion:

Physicians accepting only Medicare Part B are now subject to Section 1557 regulations. 

4.  Machine Translation Accuracy:

For critical communications, qualified human translators must review machine-generated translations to ensure accuracy and cultural appropriateness. 

Key Compliance Deadlines and Requirements Healthcare organizations are expected to meet the following compliance deadlines in the coming months and years:

November 2, 2024 

• Organizations should have appointed a Section 1557 Coordinator responsible for overseeing compliance with nondiscrimination standards.
• Notices of nondiscrimination should already be posted prominently on organization websites and physical locations. 

May 1, 2025

• Start ongoing risk assessments and mitigation for healthcare AI tools to address potential discriminatory outcomes.
• Relevant employees should be trained to ensure compliance.

July 5, 2025

• Implement comprehensive written language access procedures
• Finalize and operationalize other key policies and procedures outlined under Section 1557.  

Practical Steps for Compliance 

Here are practical steps your organization can take based on the recommendations from the webinar:

1.  Appoint a Section 1557 Coordinator

Every covered entity  with fifteen or more employees must designate a Section 1557 Coordinator. This individual (or team) will oversee compliance with nondiscrimination responsibilities, manage grievances, and train staff.

Tip: Ensure the coordinator’s role is well-defined in job descriptions and avoid overloading existing positions with this responsibility.  

2.  Train Relevant Employees 

Training is a top priority, especially for employees who interact with patients, impact healthcare decisions, or oversee compliance policies. Key training topics include nondiscrimination policies, patient rights, language access procedures, and grievance processes.

Tip: Begin training executive leadership and frontline staff on updated federal requirements as soon as possible. 

3.  Develop Written Policies and Procedures 

a. Draft or update policies for language access, grievance handling, and auxiliary aids.

b. Ensure these policies meet both federal and state-specific requirements.

c. Keep detailed records of all compliance-related activities, from training completion to the resolution of grievances. 

4.  Focus on Language Access 

Organizations must provide meaningful access to individuals with Limited English Proficiency (LEP) and those requiring auxiliary aids. This includes offering qualified interpreters and transparent information on available services.

Best Practices Include:

a. Creating an accessible repository of translated documents.

b. Auditing patient-facing materials, including consent forms and websites, for potential machine translation inaccuracies.

c. Posting clear, visible information about language access resources in waiting areas and entry points. 

5.  Monitor and Mitigate Discrimination Risks in AI 

If your organization uses AI for patient care, decision support, or operational workflows, adopt robust governance standards that align with Section 1557’s due diligence requirements.

Tip: Engage your Section 1557 Coordinator with AI governance committees to ensure compliance.  

6.  Prepare for Grievance Handling 

Adopt standardized grievance procedures for resolving claims of discrimination. 

a. A grievance must be filed within 60 days of an alleged discriminatory act.

b. Organizations typically have 30 days to respond to complaints, plus 15 days for appeals. This timeline may vary depending on your internal policies. 

Maintaining thorough documentation of grievances can protect your organization in potential investigations or lawsuits. 

Why This Matters 

Effective compliance with Section 1557 protects your organization legally and ensures equitable, inclusive care for all patients. Beyond fulfilling regulatory obligations, aligning your operations with these principles shows a commitment to civil rights, ethical medical practices, and community trust. 

Take the Next Step 

Is your organization ready for the latest Section 1557 compliance requirements? Whether you’re starting from scratch or refining existing measures, we can help your team stay ahead of regulatory changes.
Contact AMN Healthcare and explore how our tailored solutions can make compliance seamless.
Want to continue learning about Section 1557 compliance? Check out part two of our learning series.

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