Under the final rule, a covered entity cannot: deny, cancel, limit, or refuse to issue or renew a health-related insurance policy or other health-related coverage; deny or limit coverage of a claim, or impose additional cost sharing or other limitations or restrictions; or employ marketing practices or benefit designs that discriminate on the basis of race, color, national origin, sex, age, or disability. Which of the following statements is TRUE regarding the Affordable Care Act (commonly known by some as "Obamacare")? CAM is a term applied to all health-care approaches, practices, and treatments usually reimbursed by medical insurance companies. There is just one Assurance of Compliance form (Form HHS 690), and each covered entity is required to sign, date, and submit the same form. If Form 1095-A shows coverage for you and everyone in your . OCR encourages covered entities to post the notice (or statement, as applicable) in one or more of the most prevalent non-English languages frequently encountered by covered entities in their geographic service areas. of St. Johns Cnty., 968 F.3d 1286, 1305 (11th Cir. The order and accompanying decision may be found here: On August 17, 2020, the U.S. District Court for the Eastern District of New York issued an order in Asapansa-Johnson Walker v. Azar, No. b. On Thursday, the justices did just that. They may not include some rights and protections provided under the Affordable Care Act. Justices Samuel Alito and Neil Gorsuch dissented. Does Section 1557 require a covered entity with multiple locations throughout the country to have a coordinator at each of its locations to coordinate compliance with Section 1557? In order to avoid waste, fraud and abuse, and help prevent errors from occurring, the practice needs to understand each of these concepts. Since that time, the Office for Civil Rights (OCR) has been receiving and investigating discrimination complaints under Section 1557. Congressional Republicans, who made repealing the ACA a centerpiece of their political strategy, appear to have acknowledged that reality. pt. When is it permissible to treat people differently on the basis of age? Yes. A lock (LockA locked padlock) or https:// means youve safely connected to the .gov website. Please note that Section 1557 prohibits retaliation for filing a discrimination complaint. They are also required to post taglines in the top 15 languages spoken by individuals with LEP in the states in which the covered entity operates, advising consumers of the availability of free language assistance services. See 42 U.S.C. Ballot Title . For example, a State Medicaid agency should consider whether a requirement to disclose the immigration status of non-applicant parents applying for health benefits on behalf of eligible children discriminates against the eligible children on the basis of national origin because the requirement may deter parents from seeking benefits for their eligible children. 68. The Governor may call both chambers of the Utah Legislature, or only the Utah State Senate, into extraordinary session, but not the House of Representatives alone. For example, if an individual with LEP who speaks Urdu seeks information about Medicaid eligibility from a State Medicaid agency, that agency should consider and give substantial weight to the nature and importance of health insurance enrollment. The Department will also be conducting a Tribal consultation meeting on August 31, 2022 from 2:00 p.m. to 4:00 p.m. Eastern Daylight Time. Can I get a copy of the regulation in large print, Braille, or some other alternative format? Reg. Under the final rule, sex discrimination includes, but is not limited to, discrimination on the basis of pregnancy. If you purchased health care insurance through the Marketplace, you should receive a Form 1095-A, Health Insurance Marketplace Statement, at the beginning of the tax filing season.The information shown on Form 1095-A helps you complete your federal individual income tax return. The Centers for Medicare & Medicaid Services (CMS) requires the use of an addendum to the SBC to accommodate applicable language access standards[6]. Constitutional Amendment A. Supreme Court Rules Catholic Group Doesn't Have To Consider LGBTQ Foster Parents, Supreme Court Justice Brett Kavanaugh's Rise Continues To Fascinate In 'Dissent'. If so, Federal regulations limit the SBCs length to four double-sided pages[5]. For more information on how to file a complaint, click. [42]As noted in the preamble to the final rule, OCR recognizes that some covered entities will have to make changes to their health coverage to bring that coverage into compliance with the final rule; OCR is sensitive to the difficulties that making changes in the middle of a plan year could pose for some covered entities and is committed to working with covered entities to ensure that they can comply with the final rule without causing excessive disruption for the current plan year. [43]. Which of the following statements is TRUE regarding the Affordable Care Act (commonly known by some as "Obamacare")? The covered entity may not rely on a companion of an individual with a disability to interpret for that individual except in very narrow circumstances. You can read the Affordable Care Act by visiting the links below. Even then, the entity is only permitted to consider age as one factor as part of its overall decision-making. Or, should the covered entity provide the number of a telephonic oral interpretation vendor that provides qualified interpreters for the entitys health programs or activities? The final rule extends nondiscrimination protections to individuals enrolled in coverage through the Health Insurance Marketplaces and certain other health coverage. 15. What are publications and communications that are small-sized? [36] 42 U.S.C. Section 1557 went into effect on March 23, 2010.[40]. What if they contract with Managed Care Organizations or other entities to operate Medicaid managed care plans? Question: Which of the following statements is TRUE regarding the Affordable Care Act (commonly known by some as "Obamacare")? Yes, both the Federally-facilitated Marketplaces and the State-based Marketplaces are covered by Section 1557. The Section 1557 Notice of Proposed Rulemaking (NPRM) seeks to address gaps identified in prior regulations in order to advance protections under this rule. Please read each statement carefully. The previous version of this rule limited its scope to cover less programs and services limiting nondiscrimination protections. hide caption. Is the written Summary of Benefits and Coverage (SBC) required by 45 C.F.R. The final rule builds on the standards of the four Federal civil rights laws referenced in Section 1557 and their implementing regulations: Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, and the Age Discrimination Act of 1975. It requires effective communication, including through the provision of auxiliary aids and services; establishes standards for accessibility of buildings and facilities; requires that health programs provided through electronic and information technology be accessible; and requires covered entities to make reasonable modifications to their policies, procedures, and practices to provide individuals with disabilities access to a covered entitys health programs and activities. 14. The Health Insurance Marketplace | Internal Revenue Service 2020);Asapansa-Johnson Walker v. Azar, No. In the latter situation, however, only the employees who work for the health program would be covered by the rule. [1] 45 C.F.R. Individuals can also file lawsuits under Section 1557. But the majority decision threw out the challenge to the law on the grounds that Texas and other objecting GOP-dominated states were not required to pay anything under the mandate provision and thus had no standing to bring the challenge to court. For example, a hospital that provides health benefits to its employees is covered by Section 1557 in the health benefits it provides to all employees, including employees who work in the cafeteria, because the hospital is principally engaged in providing health services. 92.8 apply to significant publications or communications written in any language. OCR also encourages professional associations and organizations to consider what role they can play in helping their members meet the requirements of 92.201. 23, 2016); Jessica Sperling, Migration Policy Institute, Practitioners Corner: Drafting Request for Proposals and Contracts for Language Assistance Services, https://www.migrationpolicy.org/programs/language-access-translation-and-interpretationpolicies-and-practices/practitioners-corner-drafting (last visited May 4, 2016). Select one or more: a. Bishop, 717 P.2d at 267. The Patient Protection and Aordable Care Act (Aordable Care Act) was signed into law on March 23, 2010. Read the final rule|Read the Fact Sheet, Espaol (Spanish), (Chinese), (Simplified Chinese),Ting Vit (Vietnamese), (Korean),Tagalog (Tagalog Filipino), On May 25, 2021, the HHS Office for Civil Rights published a Notice regarding the application of Bostock v. Clayton County, GA, 140 S. Ct. 1731 (2020), to Section 1557 of the Affordable Care Act. Section 1557 imposes similar requirements on health insurance issuers that receive federal financial assistance. The law was enacted in two parts: The Patient Protection and Affordable Care Act was signed into law on March 23, 2010 6. [5] See 45 C.F.R. [13] OCR encourages covered entities to understand the strengths and weaknesses of the technology and software programs that qualified translators use.[14]. You can view them in PDF or HTML formats below. All health programs or activities that receive HHS funding; All health programs or activities administered by HHS itself (e.g., by the Centers for Medicare & Medicaid Services or the Substance Abuse and Mental Health Services Administration); and. For example, some apps for written translation are marketed as translating written content on demand. [12] 45 C.F.R. This addendum must contain only the Section 1557 nondiscrimination notice and taglines and other applicable language access information. For example, a covered entity that provides a significant publication written in Chinese must include the nondiscrimination notice (or statement, as applicable) and taglines. For example, if a Spanish-speaking individual with LEP seeks a surgery consultation regarding a gallbladder removal procedure with a physician at a large hospital, the hospital should evaluate the appropriate level, type and manner of language assistance services to be provided by considering and giving substantial weight to the nature and importance of the health care. Although Section 1557 does not require an issuer to cover a particular type of care or service, covered entities must use neutral, nondiscriminatory criteria in making decisions as to which benefits and services to cover, and their health coverage cannot operate in a discriminatory manner.[17]. 1 / 11 Flashcards Learn Test Match Created by nichole_ward2 Teacher Terms in this set (11) Individuals who choose not to purchase qualifying health care coverage will pay a tax penalty 3 MULTIPLE CHOICE OPTIONS Which of the following statements about the Affordable Care Act is TRUE? It is unlawful discrimination for a covered entity to assign staff on the basis of race, color, or national origin, even if such a request is made by a patient or resident. 11. In contrast, OCR would not generally view all of an entitys outreach, education, and marketing materials to be categorized as significant. Specifically, OCR clarifies that the following marketing publications and communications are not significant for purposes of the posting requirements in 92.8: radio or television ads; banner and banner like ads; envelopes; or outdoor advertising such as billboard ads. Bd., 972 F.3d 586, 616 (4th Cir. 1604 App. If a patient requests to be treated only by staff persons of a particular racial group, would it be a violation of the Section 1557 regulation if the covered entity honored that request? 26, 2011),https://www.medicaid.gov/Federal-Policy-Guidance/downloads/Info-Bulletin-4-26-11.pdf; HHS, CMS, Recently Released Policy GuidanceCHIPRA and the ACA, Information Bulletin 12 (Jul. The final rule also applies to employee health benefits offered by an entity that is not principally engaged in providing health care or health coverage if the entity receives Federal funding that is specifically for the employee health benefit program itself or for a particular health program. 34. On October 14, 2022, in Neese v. Becerra, 2:21-CV-163-Z (N.D. Yes. In general, covered entities may satisfy these requirements either by including the required notice and taglines on the significant publication or communication itself or by creating an insert to be enclosed with the publication or communication. By contrast, some activities may be subject to either Section 1557 or employment nondiscrimination laws but not both. In 2012, it was upheld by a 5-4 vote, with Roberts casting the decisive fifth vote, on the grounds that the penalty fell within the taxing power of Congress. If you feel that you have been subject to discrimination in health care or health coverage, you may file a complaint of discrimination under Section 1557. The Affordable Care Act allows group health plans and health insurance issuers to limit or exclude coverage only for covered individuals under 18. Correct Answer: A Topic - 1: Final AssessmentPage - 3: Final Assessment Q3 Question: Which of the following is NOT a consumer protection component of the Affordable Care Act? [7] For example, under 45 CFR 156.125(a), an issuer does not provide Essential Health Benefits if its benefit design, or the implementation of its benefit design, discriminates based on an individual's age, expected length of life, present or predicted disability, degree of medical dependency, quality of life, or other health conditions. 12101 et seq. 43. Strengthening these rules is a significant achievement for the Biden-Harris Administration and promotes gender and health equity for communities of color, women, LGBTQI+ individuals, people with disabilities, persons with limited English proficiency (LEP), and older people. For significant publications and communications that are small-sized, covered entities must post at least a nondiscrimination statement in English and taglines in at least the top two languages spoken by individuals with LEP of the State(s) served[3]. Which is true regarding health-care practitioners? 55. For example, a Health Insurance Marketplace creating a website for application for health insurance coverage must ensure that individuals with disabilities have access to the benefit of the websites tool that allows comparison of health insurance coverage options, quick determination of eligibility, and facilitation of timely access to health insurance coverage by making its new website accessible to individuals who are blind or who have low vision. It depends. 58. This approach would be permissible since the entity reasonably took age into account as one factor, among other factors that it considered. Claims under Section 1557 may be filed with HHS OCR by going to this link: https://www.hhs.gov/civil-rights/filing-a-complaint/index.html. The duty to take appropriate steps to ensure effective communication applies to communications with deaf or hard of hearing companions of patients, as well as patients. Absent any defense, issuers that are principally engaged in providing health insurance are covered for all of their activities, including off-Marketplace plans.[30]. Thus, it is not affected by the January 1, 2017, application date for benefit design changes in the regulation. Toll Free Call Center: 1-877-696-6775, Content created by Office for Civil Rights (OCR), Section 1557 of the Patient Protection and Affordable Care Act, Civil Rights for Individuals and Advocates, Temporary Assistance for Needy Families (TANF), https://www.federalregister.gov/public-inspection/2022-16217/nondiscrimination-in-health-programs-and-activities, Notification of Interpretation of Section 1557 and Title IX, Current Section 1557 implementing regulation, https://www.zoomgov.com/meeting/register/vJIsfu-rqzksEl2T8gUp_lDrWBqkU0223CY, Memorandum Opinion and Order (Jan. 19, 2021), Memorandum Opinion and Order (Oct. 15, 2019), Memorandum Opinion and Order (Aug. 17, 2020), Memorandum Opinion and Order (Oct. 29, 2020).
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