HHS Proposes Wide-Ranging Rule Barring Discrimination in Healthcare

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Includes Medicare Part B providers for first time.

What has 308 pages and discusses everything from pregnancy to Medicare Part B? It’s the proposed rule from the Department of Health and Human Services (HHS) implementing the non-discrimination parts of the Affordable Care Act (ACA).

The proposed rule, which was published August 4 in the Federal Register, implements Section 1557 of the ACA, which addresses non-discrimination in healthcare. The Biden administration has interpreted that section of the act very expansively, which means that the rule would cover a wider range of healthcare providers than it did under previous administrations, said Katie Keith, JD, MPH, director of the Health Policy and the Law Initiative at the Georgetown University Law Center in Washington. For example, it will “apply to Medicare Part B providers for the first time, and will require physicians to not be discriminatory in all these ways,” she said.

Maryanne Tomazic, JD, MPH, clinical instructor at the Harvard Law School Center for Health Law and Policy Innovation in Cambridge, Massachusetts, agreed. “This proposed rule is a lot stronger, and a welcome change for many,” she said, adding that it expands protections for several groups, including “people who are LGBTQIA. Discrimination manifests itself in the healthcare system in many ways; patients can face physical or linguistic barriers when they try to access care. Some patients have health insurance that will categorically exclude care related to gender dysphoria or other diagnoses.”

“We’ve also seen patients have insurance plans that will take groups of drugs used to treat a certain chronic condition like HIV, and put those drugs on the most expensive formulary tiers, leaving the patient and the provider with no affordable options for treatment,” Tomazic said. “The proposed rule will result in a very strong final rule that prevents these situations from happening, and where it doesn’t, it explains how people can seek redress.”

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