On August 4, 2022, the US Department of Health and Human Services (HHS) issued a Notice of Proposed Rulemaking (NPRM or proposed rule) to reinterpret section 1557 of the Affordable Care Act (ACA), which prohibits discrimination on the basis of race, color, national origin, sex, age or disability in a health program or activity, any part of which is receiving federal financial assistance. The proposed rule restores and strengthens certain civil rights protections under federally funded health programs and HHS programs which were limited following the 2020 Trump-era version of the rule, specifically regarding discrimination on the basis of sex, including sexual orientation and gender identity, and returns certain protections for individuals with limited English proficiency (LEP). Additionally, the proposed rule bolsters protections against discrimination in healthcare by clarifying that funds received under several federal healthcare programs, including Medicare Part B, are included in the definition of federal financial assistance under the law. As such, under the proposed rule, the list of entities expected to comply with the nondiscrimination measures outlined in Section 1557 of the ACA is significantly expanded, in many ways aligning with the 2016 Obama-era version of the rule. The NPRM also proposes to expand the applicability of the post-Bostock interpretation of “on the basis of sex” to Medicaid, Children’s Health Insurance Programs (CHIP) and Programs of All-Inclusive Care for the Elderly (PACE). For now, portions of the 2020 Final Rule not discordant with Bostock continue to apply.
HHS Issues Proposed Rule Under Section 1557 of the Affordable Care Act: Nondiscrimination in Health Programs and Activities
Gregory FosheimGregory E. Fosheim provides counsel on a wide array of corporate, transactional and regulatory compliance matters across the healthcare and life sciences industry. Drawing on his extensive laboratory and public health background and insight, he regularly advises on clinical and diagnostic laboratory matters, anatomic pathology and fertility laboratory compliance. Greg also represents hospitals, health systems and physician practice management companies in all aspects of transactional and operational matters, particularly those with regulatory, licensing, accreditation and policy considerations, and he has negotiated several acquisitions and sales of proton therapy centers. Read Gregory Fosheim’s full bio.
Jacob MattinsonJacob M. Mattinson focuses his practice on employee benefits and matters related to 401(k), 403(b), pension, executive compensation, health care reform, and cafeteria and welfare plans. Jacob assists clients in drafting employee benefit plan documents and amendments. He represents clients in matters before the Internal Revenue Service (IRS), US Department of Labor (DOL) and Pension Benefit Guaranty Corporation with respect to plain qualification issues. Read Jacob Mattinson's full bio.
Todd SolomonTodd A. Solomon focuses his practice on designing, amending and administering pension, profit sharing, 401(k), employee stock ownership and 403(b) plans, as well as nonqualified deferred compensation arrangements. He also counsels privately and publicly held corporations and tax-exempt entities regarding fiduciary issues under the Employee Retirement Income Security Act (ERISA), employee benefits issues involved in corporate transactions, executive compensation matters and the implementation of benefit programs for domestic partners of employees.Read Todd A. Solomon's full bio.
Moyosore KoyaMoyosore (Moyo) O. Koya works with healthcare clients, particularly hospitals and health systems, on a wide range regulatory and reimbursement issues. Moyo is experienced with federal Medicare and Medicare Advantage plans, including revenue recovery and complex claim reimbursement matters. Read Moyosore O. Koya's full bio.
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