Section 1557
ACA healthcare nondiscrimination provision.
Section 1557 of the Patient Protection and Affordable Care Act (ACA) prohibits discrimination based on race, color, national origin, sex, age, or disability in health programs and activities that receive federal financial assistance. For language services, Section 1557 requires covered entities to provide language assistance services free of charge to LEP individuals and qualified sign-language interpretation for deaf and hard-of-hearing patients.
Covered entities include virtually all hospitals (as Medicare/Medicaid recipients), Federally Qualified Health Centers, many physician practices, and health insurance issuers. Section 1557 requires:
- Qualified interpreters in patient encounters where language assistance is needed. Bilingual staff who haven't been assessed and trained as qualified interpreters cannot substitute.
- Notice of Nondiscrimination in significant publications and at significant entry points (websites, patient portals, registration desks).
- Taglines indicating availability of language services in the top 15 languages spoken by LEP populations in the relevant state.
- Free, timely access — covered entities cannot charge LEP patients for interpretation or translation.
Enforcement is by the Department of Health and Human Services Office for Civil Rights. Penalties include corrective action plans and, in egregious cases, loss of federal funding.