Affordable Care Act of 2010 – Section 1557 – Grievance Procedure Requirements for Discrimination

PUBLISHED: Sep 27, 2016

The final rule implementing Section 1557 of the Affordable Care Act of 2010 (Section 1557) requires covered entities with 15 or more employees to have a grievance procedure and a compliance coordinator. Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age or disability in certain health programs and activities.

All covered entities should have a written policy that reflects the fact that it does not discriminate on the basis of race, color, national origin, sex, age or disability. The organization must adopt a grievance procedure that provides for the prompt and equitable resolution of complaints alleging any action prohibited by Section 1557 of the Affordable Care Act (42 U.S.C. § 18116) and its implementing regulations at 45 CFR part 92, issued by the U.S. Department of Health and Human Services.

Any person who believes someone has been subjected to discrimination on the basis of race, color, national origin, sex, age or disability may file a grievance under Section 1557; organizations shall not retaliate against anyone who opposes discrimination, files a grievance, or participates in the investigation of a grievance

Each organization should have a Section 1557 Coordinator who is responsible receiving, investigation and responding to Section 1557 grievances.

The final rule outlines specific time requirements with respect to the grievance procedure:

  • Grievances must be submitted to the Section 1557 Coordinator within sixty (60) days of the date the person filing the grievance becomes aware of the alleged discriminatory action
  • A written decision on the grievance, based on a preponderance of the evidence, must be provided no later than thirty (30) days after its filing and should include a notice to the complainant of their right to pursue further administrative or legal remedies

Included with today’s notice is an example Section 1557 grievance procedure.

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