Affordable Care Act

Section 1557 of the Affordable Care Act (ACA) is the law’s primary nondiscrimination provision, prohibiting discrimination based on race, color, national origin, sex (including gender identity and sexual orientation), age, or disability in federally funded health programs or activities.

Reporting Requirements for Physicians Under Section 1557

Physicians and healthcare providers covered by this rule must comply with the following requirements:

  1. Nondiscrimination Policies & Notice Requirements • Providers must post notices of nondiscrimination in visible locations, including websites, waiting rooms, and patient documents. • They must also inform patients about language assistance services and accommodations for disabilities.
  2. Grievance Procedure & Compliance Officer • Large practices (15+ employees) must designate a Section 1557 Coordinator to handle compliance. • They must implement a grievance procedure for discrimination complaints.
  3. Language & Accessibility Services • Providers must offer free language assistance services, such as interpreters and translated materials, for patients with limited English proficiency (LEP). • They must provide accessible formats (e.g., Braille, large print) for patients with disabilities.
  4. Sex Discrimination & Gender Identity Protections • Providers cannot deny care based on sex, gender identity, or sexual orientation. • This includes equal access to gender-affirming care if they offer similar services to other patients.
  5. Compliance & Enforcement • HHS’s Office for Civil Rights (OCR) enforces Section 1557. • Providers must report compliance with nondiscrimination policies and may be investigated if complaints arise. • Violations can result in financial penalties, loss of federal funding, or legal action.

How Physicians Report Compliance or Violations

  • To report compliance, providers should maintain internal policies, train staff, and keep records of language services.
  • To report violations, patients or providers can file complaints with the HHS OCR within 180 days of the incident.

To report a violation of Section 1557 of the Affordable Care Act to the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR), you have several options:

📝 How to File a Complaint

  1. Online via the OCR Complaint Portal
    1. Visit the OCR Complaint Portal.
    2. Select the type of complaint and fill out the required information.
    3. Electronically sign and submit the complaint.
    1. By Email or Mail
      1. You can also file a complaint in writing using your own format or the official complaint form package.
      2. Email: Send to OCRComplaint@hhs.gov
      3. Mail:
        • Centralized Case Management Operations
          U.S. Department of Health and Human Services
          200 Independence Avenue, S.W.
          Room 509F HHH Building
          Washington, D.C. 20201
        • Include:
          Your name and contact information
          Name and contact info of the provider or organization
          Description of the discriminatory act (what happened, when, and why it was discriminatory)
          Your signature and the date
  3. Deadline
    1. Complaints must be filed within 180 days of the alleged discrimination. Extensions may be granted for good cause.

[1] Complaint Process | HHS.gov

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