Questions about ACA non-discrimination rule? AAD has answers

Helms_Stephen.jpgBy Stephen E. Helms, MD
Chair, AAD Practice Management Committee

Are you confused about the Affordable Care Act’s non-discrimination rule? If so, you’re not alone.

The Academy has received dozens of calls from members seeking clarification about the rule. To help answer your questions, the AAD has compiled essential information to help advise you on how the rule applies to your practice and how to comply with it.

Section 1557 infographic

What is the rule?

The Affordable Care Act’s section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age, or disability when providing medical care. The rule applies to dermatology practices and requires that the practice take reasonable steps to provide timely and meaningful access to care for all patients without discrimination. Dermatology practices must adhere to nondiscriminatory standards and practices when treating patients with disabilities and/or with limited English proficiency by providing auxiliary aids, assistance, and/or qualified interpreters. (See #4 below.)

How does my practice comply? 

  1. Designate a compliance officer to assess the requirements and document all requirements. Review FAQs explaining Section 1557

  2. By Oct. 16, 2016, post a Notice of Nondiscrimination policy (download model policy) on both your practice’s website and in a conspicuous office location so that it's visible to patients. You must also post taglines (view model taglines) in at least the top fifteen non-English languages spoken in the state

  3. You must also post the notice and taglines on any documents you provide patients addressing patient care. If it is an electronic document, include a link to the Notice of Nondiscrimination policy and taglines.

  4. In the event patients need interpreters, you should investigate local language assistance resources, either through the current interpreting vendor used for complying with the ADA, a local affiliated hospital, your state medical association’s list of language interpreting services, or a new language interpreting vendor you identify in your area. When contracting with a vendor, negotiate a per-use basis contract, which is not only useful but cost-effective. Note: patients needing interpreting services cannot be charged for this service, neither under this nondiscrimination regulation nor the ADA.    

  5. Practices may want to combine the Nondiscrimination Notice with other compliance protocols when notifying patients of their rights (e.g., HIPAA Notice of Privacy Practice) as an efficient and cost-effective approach to compliance.

  6. If you have 15 or more employees, you must develop a grievance procedure to manage complaints. Learn more about developing and managing a grievance procedure.

The Office for Civil Rights (OCR) will be updating their website periodically with additional information, technical guidance, and model forms. Be sure to check in routinely to minimize risks of complaints and investigations at

AAD compliance resources: