Dive Brief:
- A proposed rule the HHS announced Monday seeks to strengthen civil rights and nondiscrimination protections for patients and consumers under Section 1557 of the Affordable Care Act.
- A previous version of the rule enacted under the Trump administration limited its scope and power to cover fewer programs and services, officials said on a call with reporters Monday.
- The newly proposed version, which prohibits discrimination on the basis of race, color, national origin, sex, age and disability in healthcare programs, interprets Medicare Part B as federal financial assistance for the first time.
Dive Insight:
The Obama administration first issued regulations on discrimination, but the Trump administration stripped a number of protections, notably those regarding sexual orientation and gender identity.
Officials clarified on a call with reporters Monday that the new rule would reinstate such protections, and that it covers both providers and insurers that receive federal financial assistance. That includes telehealth providers and Medicare Part B, which covers some doctors visits, preventive care and outpatient care, among other services.
“Everyone in America should be able to get the care that they need from any health provider in the country, especially if that provider is receiving funding from HHS,” Secretary Xavier Becerra said on the call.
“We want to make sure that Americans are free from discrimination when they try to access the care that they need,” he said.
Other tweaks in the new rule include broadening language accessibility services and requiring covered entities to provide alternate communication formats for patients with disabilities or those who require auxiliary aids. Accommodations also must be made for people who do not speak English.
Another notable change includes language around clinical algorithms, prohibiting discrimination through the use of that technology in healthcare settings.
Research has found AI algorithms used for decision making in patient care can be racially biased and lawmakers in the past have pushed for greater oversight.
The previous version of the rule under Trump eliminated the prohibition of discrimination based on gender identity, along with specific health insurance coverage protections for transgender individuals, according to an analysis from the Kaiser Family Foundation.
Shortly after that rule was published, the U.S. Supreme Court ruled in Bostock v. Clayton County that employers cannot fire employees on the basis of sexual orientation or gender identity.
The new rule would affirm covered healthcare entities cannot discriminate on the basis of sexual orientation or gender identity, consistent with the court’s decision, according to an HHS release.