2022-16217: Nondiscrimination in Health Programs and Activities

Summary

The Department of Health and Human Services (HHS or the Department) is issuing this proposed rule on Section 1557 of the Affordable Care Act (ACA) (Section 1557). Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs and activities. Section 1557(c) of the ACA authorizes the Secretary of the Department to promulgate regulations to implement the nondiscrimination requirements of Section 1557. The Department is also proposing to revise its interpretation regarding whether Medicare Part B constitutes Federal financial assistance for purposes of civil rights enforcement and to revise nondiscrimination provisions to prohibit discrimination on the basis of sexual orientation and gender identity in regulations issued by the Centers for Medicare & Medicaid Services (CMS) governing Medicaid and the Children's Health Insurance Program (CHIP); Programs of All-Inclusive Care for the Elderly (PACE); health insurance issuers and their officials, employees, agents, and representatives; States and the Exchanges carrying out Exchange requirements; agents, brokers, or web-brokers that assist with or facilitate enrollment of qualified individuals, qualified employers, or qualified employees; issuers providing essential health benefits; and qualified health plan issuers.

The agency’s own summary, as published.

What this changes

Amends 12 parts of the Code of Federal Regulations — the standing rules this notice rewrites.

• 42 CFR 438 Managed Care
• 42 CFR 440 Services: General Provisions
• 42 CFR 457 Allotments and Grants to States
• 42 CFR 460 Programs of All-Inclusive Care for the Elderly (PACE)
• 45 CFR 80 Nondiscrimination Under Programs Receiving Federal Assistance Through the Department of Health and Human Services Effectuation of Title VI of the Civil Rights Act of 1964
• 45 CFR 84 Nondiscrimination on the Basis of Disability in Programs or Activities Receiving Federal Financial Assistance
• 45 CFR 86 Nondiscrimination on the Basis of Sex in Education Programs or Activities Receiving Federal Financial Assistance
• 45 CFR 91 Nondiscrimination on the Basis of Age in Programs or Activities Receiving Federal Financial Assistance from HHS
• 45 CFR 92 Nondiscrimination in Health Programs or Activities
• 45 CFR 147 Health Insurance Reform Requirements for the Group and Individual Health Insurance Markets
• 45 CFR 155 Exchange Establishment Standards and Other Related Standards Under the Affordable Care Act
• 45 CFR 156 Health Insurance Issuer Standards Under the Affordable Care Act, Including Standards Related to Exchanges