Section 1557 Of The Affordable Care Act Applies To What?

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Section 1557 Of The Affordable Care Act Applies To What?

Section 1557 makes it unlawful for any health care provider that receives funding from the Federal government to refuse to treat an individual – or to otherwise discriminate against the individual – based on race, color, national origin, sex, age or disability.

Who does Section 1557 apply to?

the Department of Health and Human Services
The Section 1557 final rule applies to recipients of financial assistance from the Department of Health and Human Services (HHS), the Health Insurance Marketplaces and health programs administered by HHS.

Which programs are covered by ACA Section 1557?

Federal financial assistance includes grants, property, Medicaid, Medicare Parts A, C and D payments, and tax credits and cost-sharing subsidies under Title I of the ACA.

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What is the 1557 rule?

Section 1557 is the nondiscrimination provision of the ACA. It builds on longstanding nondiscrimination laws and prohibits discrimination based on race, color, national origin (including Limited English Proficiency), age, disability or sex.

Who enforces Section 1557 of the Affordable Care Act?

The HHS Office for Civil Rights (OCR) is responsible for accepting and investigating Section 1557 complaints. Section 1557 is the first federal civil rights law to prohibit discrimination on the basis of sex in covered health programs and activities.

Which of the following best describes the scope of operations subject to Section 1557?

Which of the following statements best describes the scope of operations subject to Section 1557 under the 2020 Final Rule? … The scope of operations subject to Section 1557 under the Trump Administration’s 2020 Final Rule remains the same as the scope of operations covered by the Obama Administration’s 2016 Final Rule.

Which entity enforces Section 1557 for programs that receive funding by HHS?

Section 1557 has been in effect since its enactment in 2010 and the HHS Office for Civil Rights (OCR) has been enforcing the provision since it was enacted.

Does section 1557 apply to self funded plans?

Under the 2020 rule, Section 1557 generally does not apply to self-funded group health plans under ERISA or short-term limited duration plans because the entities offering the plans are typically not principally engaged in the business of providing health care, nor do they receive federal financial assistance.

Which area of potential discrimination is not generally covered by ACA Section 1557 quizlet?

Loss of federal business and compensatory damages. Which area of potential discrimination is not generally covered by ACA Section 1557? Employment (with the exception of the provision of health insurance).

What protections does the Patient Protection and Affordable Care Act provide to consumers with disabilities?

The Affordable Care Act prohibits discrimination based on disability under any health program or activity that receives federal funding or assistance. Prior to ACA, plans could refuse to provide coverage to people with disabilities or other chronic health conditions.

What are the possible consequences of violations of ACA section 1557 for a health plan?

Eligibility for coverage. As a result of violations of ACA Section 1557 nondiscrimination rules, a. health plans may be fined, but their agents and brokers are not affected.

What is permitted in dealing with a person with limited English proficiency?

Protections for Individuals with Limited English Proficiency

Reasonable steps may include the provision of language assistance services, such as oral language assistance or written translation.

What is HHS rule?

HHS enforces federal civil rights laws that protect the rights of individuals and entities from unlawful discrimination on the basis of race, color, national origin, disability, age, or sex in health and human services.

Which entity enforces Section 1557 for programs that receive funding quizlet?

While the HHS Office for Civil Rights’ enforcement of Section 1557 is substantially narrowed under the rule, in terms of the scope of covered entities and the type of claims constituting prohibited discrimination, federal courts could continue to apply Section 1557’s statutory protections more broadly and provide …

What federal law requires that all providers who accept federal funds for healthcare insurance equal access to services?

The ADA requires that health care entities provide full and equal access for people with disabilities. This can be done through: Reasonable Modifications of Policies, Practices, and Procedures.

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Are health insurers exempt from Section 1557?

In the final rule, the administration also eliminates regulations prohibiting discriminatory plan benefit design and marketing, and exempts most insurance companies and private health plans from Section 1557 nondiscrimination requirements.

Which act prohibits discrimination in group health plan coverage?

Section 1557 is the civil rights provision of the Affordable Care Act of 2010. Section 1557 prohibits discrimination on the ground of race, color, national origin, sex, age, or disability in certain health programs and activities.

What law requires that an organization can be sued if consumers who are limited English proficient are not provided language services when requested?

Title VI of the Civil Rights Act of 1964 requires recipients of Federal financial assistance to take reasonable steps to make their programs, services, and activities accessible by eligible persons with limited English proficiency.

What are some of the laws governing Medicare Parts C and D?

Some of the laws governing Medicare Parts C and D Fraud, Waste, and Abuse (FWA) include the Health Insurance Portability and Accountability Act (HIPAA); the False Claim Act; the Anti-Kickback Statute; the List of Excluded Individuals and Entities (LEIE); and the Health Care Fraud Statute.

What is the definition of waste Medicare quizlet?

CMS provides this definition in its compliance guidance for Medicare plans: “WASTE is the overutilization of services, or other practices that, directly or indirectly, result in unnecessary costs to the Medicare program. … *This is WASTE, because it results in unnecessary healthcare expenditures.

What did the Patient Protection and Affordable Care Act do?

The law provides numerous rights and protections that make health coverage more fair and easy to understand, along with subsidies (through “premium tax credits” and “cost-sharing reductions”) to make it more affordable. The law also expands the Medicaid program to cover more people with low incomes.

What did the Affordable Care Act do?

It was designed to extend health coverage to millions of uninsured Americans. The act expanded Medicaid eligibility, created a Health Insurance Marketplace, prevented insurance companies from denying coverage due to pre-existing conditions, and required plans to cover a list of essential health benefits.

What are the major provisions of the Affordable Care Act quizlet?

Key provisions of the ACA that intend to address rising health costs include providing more oversight of health insurance premiums and practices; emphasizing prevention, primary care and effective treatments; reducing health care fraud and abuse; reducing uncompensated care to prevent a shift onto insurance premium …

Which of the following statements best describes Section 1557 of the Affordable Care Act ACA quizlet?

Limit benefits and services. Cannot deny coverage to LEP individuals and is required to provide language assistance to them, free of charge. Policies and procedures, physical access, and communication. Which of the following statements best describes Section 1557 of the Affordable Care Act (ACA)?

How is limited English proficiency determined?

A. Individuals who do not speak English as their primary language and who have a limited ability to read, speak, write, or understand English can be limited English proficient, or “LEP.” These individuals may be entitled language assistance with respect to a particular type or service, benefit, or encounter.

What is limited language proficiency?

Limited English proficiency (LEP) is a term used in the United States that refers to a person who is not fluent in the English language, often because it is not their native language.

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What is a limited English proficient student?

Limited English proficient is the term used by the federal government, most states, and local school districts to identify those students who have insufficient English to succeed in English-only classrooms.

What law regulates the healthcare industry?

HIPAA. The federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) was originally passed to protect healthcare for workers between jobs. These days, HIPAA is most directly associated with the protection of confidential patient healthcare information.

Which of the following requires intent to obtain payment and the knowledge?

Fraud requires the person have intent to obtain payment and the knowledge that their actions are wrong.

Which one of the following statements best describes the aim of integrity?

Which one of the following statements best describes the aim of integrity? Ensuring that information and/or systems have not been altered in an unauthorized way.

What does Section 1557 require?

Section 1557 and its implementing regulation (Section 1557) require covered entities to post – in their significant publications and communications – nondiscrimination notices in English, as well as taglines in at least the top 15 languages spoken by individuals with limited English proficiency (LEP) in the State(s) …

Who enforces Section 1557 of the Affordable Care Act?

The HHS Office for Civil Rights (OCR) is responsible for accepting and investigating Section 1557 complaints. Section 1557 is the first federal civil rights law to prohibit discrimination on the basis of sex in covered health programs and activities.

Which Medicare programs are covered by ACA Section 1557?

Federal financial assistance includes grants, property, Medicaid, Medicare Parts A, C and D payments, and tax credits and cost-sharing subsidies under Title I of the ACA. (Medicare Part B is not included.)

What is a covered entity under Section 1557?

Under Section 1557 of the Affordable Care Act (Section 1557), “covered entities,” which were defined as health programs or activities that receive “federal funding” from the U.S. Department of Health and Human Services (HHS) cannot discriminate on the basis of race, color, national origin, disability, age or sex.

Does section 1557 apply to self funded plans?

Under the 2020 rule, Section 1557 generally does not apply to self-funded group health plans under ERISA or short-term limited duration plans because the entities offering the plans are typically not principally engaged in the business of providing health care, nor do they receive federal financial assistance.

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