On May 18, 2016, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) issued a final rule on Section 1557 of the Affordable Care Act that prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs and activities.
This final rule seeks to expand access to healthcare and coverage, eliminating barriers and reducing health disparities. It specifically prohibits sex discrimination under federal law, and outlines requirements regarding special notices for individuals with Limited English Proficiency (LEP) and nondiscrimination disclosures. This article is to alert you of the potential impact on your benefit plans.
What is Section 1557?
This final rule took effect on July 18, 2016 and implements section 1557 of the Patient Protection and Affordable Care Act (ACA) (Final Rule). It impacts certain health issuers, health programs, and group health plans.
The Final Rule makes it clear that individuals cannot be denied health care or health coverage based on their race, color, national origin, age, disability and sex, including their gender identity or sex stereotyping. It also states that individuals cannot be subject to limitations or restrictions on health coverage on a discriminatory basis.
What is the impact on health plans?
We’ve reviewed our plans for compliance with the law and if benefit changes are required we will provide an update to you at www.bluecrossma.com/straight-answers. One of the impacts this final rule has on health plans is the declaring of any categorical coverage exclusions or limitations for all health care services related to gender transition as discriminatory. We currently offer our members, in all our plans, coverage for gender reassignment surgeries and related services.
This Final Rule has many requirements, and in an attempt to keep you informed on these changes, we encourage you to visit the following sites to review the information provided: