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Final Rule Issued on Nondiscrimination in Health Programs and Activities

gavel with sign that reads discrimination

1.5 minute read

The U.S. Department of Health and Human Services’ (HHS) Office of Civil Rights (OCR) issued a final rule under Section 1557 of the Affordable Care Act. It prohibits discrimination based on color, race, sex, age, national origin, or disability in certain health programs and activities. The final rule will be published on May 6, 2024, taking effect 60 days later with varying effective dates for certain provisions.



The OCR's rules for Section 1557 have faced lawsuits on health program discrimination and the scope of sex discrimination, excluding gender identity and pregnancy termination in 2020 regulations.


2024 Final Rule Highlights

The final rule expands the scope of prior 2020 regulations by providing that:

  • Health insurance issuers are covered under section 1557 and it applies to all HHS-administered health programs and activities;
  • Sex discrimination protections include discrimination on the basis of sexual orientation and gender identity, as well as sex stereotypes, sex characteristics, and pregnancy or related conditions; and
  • Any health programs and activities provided through telehealth services are subject to nondiscrimination requirements.

Also, entities covered by the file rule are required to:

  • Implement and train staff on policies and procedures to ensure final rule compliance;
  • Notify individuals that language assistance services and auxiliary aids are available if needed; and
  • Take steps to identify and mitigate discrimination when they use patient care decision support tools.


Action Steps

The final rule is likely to become the subject of more lawsuits. Plan administrators and issuers should monitor all legal developments in consultation with benefits counsel and work closely with their benefits advisors in complying with their Section 1557 obligations. The latest updates can be found on the OCR Section 1557 webpage. Download the bulletin for more details.

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National Insurance Services is not a law firm and no opinion, suggestion, or recommendation of the firm or its employees shall constitute legal advice. Readers are advised to consult with their own attorney for a determination of their legal rights, responsibilities and liabilities, including the interpretation of any statute or regulation, or its application to the readers’ business activities.

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Bill Chukuske

Bill Chukuske

Bill Chukuske is a man of his word. His clients find him honest, sincere, trustworthy, and he always does what he said he’ll do. He believes in “taking care of his customers and everything else will fall into place”. Bill was self-employed for 20 years, building his own insurance company from the ground up, serving mostly public sector organizations. As an Employee Benefits Consultant with National Insurance Services, Bill is responsible for the overall assessment and management of all an employer’s benefit plans. He is a licensed insurance agent and works with schools, cities, and counties in the Midwest Region.