New nondiscrimination rule: How will it affect your home care booklets?

By this point, most home care agencies have heard chatter about a new regulation that impacts both home care agencies and patient orientation booklets.  We thought it would be helpful to outline and provide references to the regulation.


The Department of Health and Human Services (HHS) Nondiscrimination Rule requires implementing the prohibition of discrimination under Section 1557 of the Affordable Care Act (ACA) of 2010.  The final rule, Nondiscrimination in Health Programs and Activities, explains consumers’ rights under the law and adds certain requirements for covered entities in order to ensure nondiscrimination on the grounds of race, color, national origin, sex, age or disability in certain health programs and activities.  Entities covered under the rule are any health program or activity which receives funding from HHS; any health program that HHS itself administers; Health Insurance Marketplaces; and issuers that participate in those Marketplaces.

Source: 45 CFR Part 92, Nondiscrimination in Health Programs and Activities; Final Rule, published May 18, 2016, effective July 18, 2016, implementation date October 17, 2016,

How this Affects Your Patient Orientation Booklets

Sections will need to be added to your patient orientation booklet to comply with this new rule.  MedForms has finalized the required updates to include in the orientation booklets for home health, hospice, etc.  An overview of these changes is as follows:

  • Language Assistance Services – Agencies must provide patients with language assistance, free of charge, and must notify their patients of this service in the top 15 non-English languages spoken in their state. [§92.8(e)-(f)]. MedForms will update your booklet with short taglines in those 15 languages, stating the agency offers this service. You will be asked to fill in the appropriate phone numbers for non-English speaking patients to call for language assistance, depending on your agency’s protocol.
  • Notice of Nondiscrimination/Filing a Grievance – A new section will be added to your booklet informing patients about nondiscrimination, accessibility requirements and the availability of language assistance services, as well as to provide home care patients with the agency’s procedure on submitting, reviewing and resolving discrimination grievances [(I)(C)(2) Notice Requirement and § 92.7 Designation of responsible employee and adoption of grievance procedures].  You will be asked to submit your current nondiscrimination grievance procedure or customize the sample verbiage to match your agency’s policies and procedures.

Important Dates

The new regulation was effective July 18; however, the Office of Civil Rights (OCR) made provisions in the regulation that gives covered entities 90 days to from the effective date (roughly October 17, 2016) to implement the notice requirements.  The OCR also includes a provision in the new regulation allowing home care agencies to exhaust their existing supply of publications and communications.

As always, please feel free to contact us with any questions or concerns.  Thank you for entrusting your patient orientation booklets to us!  We are grateful for your continued business.

Additional Information: HHS OCR Offers New Materials for Covered Entities

Earlier this year, HHS OCR finalized the rule under Section 1557 to advance health equity and reduce health disparities by strengthening protections for some of the populations that have been most vulnerable to discrimination in the health care context.  Section 1557 is the nondiscrimination provision of the Affordable Care Act and states that individuals cannot be subject to discrimination based on their race, color, national origin, sex, age or disability.

As of Monday, July 18, 2016, certain health care and coverage providers are subject to new requirements under Section 1557 and are expected to ensure their programs are in compliance with the law.  HHS OCR has added a number of downloadable resources to our website to reduce burden for covered entities.  Certain parts of the rule have a delayed applicability date and we encourage covered entities to review the procedural requirements of the final rule.

Available Materials:

  • Training materials for health care providers and employees of health programs and insurance issuers programs has also been added to our website. These training materials include a slide deck and a presenter’s guide. Click here for training materials.
  • Covered entities with 15 or more employees are required to have a grievance procedure and a compliance coordinator. A model grievance procedure is available on our website
  • Beginning October 17, 2016, covered entities will be required to post Notices of Nondiscrimination and Taglines that alert individuals with limited English proficiency (LEP) to the availability of language assistance services.  Sample documents of a Notice of Nondiscrimination, Statement of Nondiscrimination and Taglines are available for download in 64 languages. Click here for translated materials.

Additional information about Section 1557, including fact sheets on key provisions and frequently asked questions, are also available on our website. These materials are translated in the top 15 languages nationally.

For questions about Section 1557 and the availability of materials, contact HHS OCR at

To learn more about non-discrimination and health information privacy laws, your civil rights, and privacy rights in health care and human service settings, and to find information on how to file a complaint, visit us at


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