Section 1557 is the nondiscrimination section of the Affordable Care Act, and HHS's 2024 rule turned parts of it into specific website duties: posted notices, language-assistance taglines and accessible digital content. Law-firm alerts cover the whole rule. This page sticks to what touches a practice's website, with every requirement and date checked against the regulation text and the Federal Register on October 22, 2026, and the litigation flagged.
The term draws 590 searches a month in the US with low competition (keyword difficulty 14), and "section 1557 final rule" 20 (Google Ads Keyword Planner data via DataForSEO, US, 12-month average to Sep 2026).
Section 1557 in one paragraph
Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age or disability in health programs and activities that receive federal financial assistance, programs HHS runs, and entities set up under the ACA. HHS's current rule, published May 6, 2024 (opens in a new tab) and effective July 5, 2024 (opens in a new tab), sits at 45 CFR part 92. For your website, it matters in three places: notices you must post, language access, and accessibility of online content.
Who it covers: practices that receive federal financial assistance
The rule's definitions (opens in a new tab) make a "covered entity" any recipient of federal financial assistance, and list a "physician's practice" among the entities whose operations count as a health program or activity.
The bigger change for practices is Medicare Part B. HHS's long-standing position had been that Part B payments were not federal financial assistance. In the 2024 rule, the department finalized the opposite interpretation: Part B funding "meets the definition of 'Federal financial assistance'" for Title VI, Title IX, Section 504, the Age Act and Section 1557. Entities whose only federal program participation was Part B had until May 6, 2025 to comply and to file an assurance of compliance. HHS also noted that almost all practicing physicians were likely covered already through other federal funding.
In plain terms: if your practice bills Medicare, Medicaid or another federal program, assume Section 1557 applies and confirm with counsel. If you're entirely cash-pay with no federal funds, it may not. HIPAA coverage is a separate question; see who HIPAA applies to.
What the 2024 final rule changed
For a practice, the main additions were:
- A Section 1557 coordinator for covered entities that employ 15 or more persons, under 45 CFR 92.7 (opens in a new tab).
- Written policies and procedures on nondiscrimination, language access, effective communication and reasonable modifications, under 45 CFR 92.8 (opens in a new tab). Grievance procedures apply to entities with 15 or more persons.
- Staff training on those policies.
- Two notices, described below, including on your website.
- Accessible information and communication technology, described below.
- Patient care decision support tools. Covered entities must make reasonable efforts to identify tools that use race, color, national origin, sex, age or disability as inputs, and to mitigate the risk of discrimination, under 45 CFR 92.210 (opens in a new tab).
Litigation status. On October 22, 2025, the U.S. District Court for the Southern District of Mississippi, in Tennessee v. Kennedy, vacated provisions of the rule to the extent they extend sex discrimination to gender identity. HHS's June 2, 2026 notice (opens in a new tab) lists the affected provisions, including part of the nondiscrimination notice requirement (92.10(a)(1)(i)) to that extent, and states that "the other provisions of the Section 1557 Rule remain in force." Courts can issue new orders, so recheck before relying on any provision.
Digital accessibility: how Section 1557 and Section 504 fit together
Section 1557 sets the duty; Section 504 supplies the technical standard.
- Section 1557. Under 45 CFR 92.204 (opens in a new tab), covered entities must make health programs offered through information and communication technology (ICT) accessible to people with disabilities. The rule's definition of ICT expressly includes "websites; videos; and electronic documents". Recipients must make sure programs offered through websites and mobile apps comply with Section 504.
- Section 504. HHS's 2024 Section 504 rule, at 45 CFR 84.84 (opens in a new tab), requires recipients' web content and mobile apps to meet WCAG 2.1 Level A and AA success criteria. That includes content provided through contractors and vendors.
An interim final rule effective May 7, 2026 (opens in a new tab) moved the Section 504 web compliance dates to May 11, 2027 for recipients with 15 or more employees and May 10, 2028 for those with fewer. The standard itself didn't change. Our ADA compliant website guide covers WCAG and the common fixes. Medfy makes no claim that any website, including those it builds, conforms to WCAG.
Notices, taglines and language access on your website
Two notices must appear on a covered entity's website, if it has one. Checked against the regulation text on October 22, 2026:
Notice of nondiscrimination, under 45 CFR 92.10 (opens in a new tab). Posted "at a conspicuous location" on the website, and in physical locations in no smaller than 20-point sans serif type. It must state that you don't discriminate on the protected grounds; that free auxiliary aids, reasonable modifications and language assistance are available and how to get them; your Section 1557 coordinator's contact details and grievance procedure, if applicable; and how to file a complaint with HHS's Office for Civil Rights.
Notice of availability of language assistance and auxiliary aids, under 45 CFR 92.11 (opens in a new tab). Provided in English and in "at least the 15 languages most commonly spoken by individuals with limited English proficiency" in your state or states, and posted at a conspicuous location on the website. It also accompanies listed documents such as intake forms, consent forms and billing statements, with opt-out and alternative routes set out in the rule.
Illustrative example, compliant approach (fictional practice): Every page footer on a family practice's site has two text links, "Nondiscrimination notice" and "Language assistance", next to "Notice of Privacy Practices". Each opens an HTML page, with the taglines in real text that screen readers and translation tools can read.
Illustrative example, non-compliant approach (fictional practice): A clinic's only notice is a scanned PDF linked from the bottom of its About page, with the language taglines in an image that screen readers can't read.
Our list of notices your website must post puts these alongside the HIPAA Notice of Privacy Practices.
Compliance dates to verify
From the rule's compliance schedule (opens in a new tab) and later Federal Register notices. All dates checked October 22, 2026.
| Requirement | Compliance date |
|---|---|
| Rule effective | July 5, 2024 |
| Section 1557 coordinator (92.7) | Within 120 days of July 5, 2024 (November 2, 2024) |
| Notice of nondiscrimination (92.10) | Within 120 days of July 5, 2024 (November 2, 2024) |
| Policies and procedures (92.8) | Within one year of July 5, 2024 (July 5, 2025) |
| Language assistance notice (92.11) | Within one year of July 5, 2024 (July 5, 2025) |
| Training (92.9) | After policies are implemented, no later than one year of July 5, 2024 |
| Patient care decision support tools (92.210(b) and (c)) | Within 300 days of July 5, 2024 |
| Entities whose only federal funding is Medicare Part B | May 6, 2025 |
| Section 504 web accessibility, 15 or more employees | May 11, 2027 |
| Section 504 web accessibility, fewer than 15 employees | May 10, 2028 |
Most Section 1557 dates have passed. If your practice is covered and hasn't posted the notices, it's already late.
What to do now: a practice checklist
- Confirm coverage with counsel, starting with whether you receive Medicare Part B or other federal funds.
- Post both notices on your website as text pages, linked from every page footer.
- Prepare the language taglines for at least the 15 languages most commonly spoken by people with limited English proficiency in your state, and attach the notice to intake, consent and billing documents.
- Name a coordinator and adopt written policies if you employ 15 or more people.
- Audit your website for accessibility against WCAG 2.1 AA, starting with forms, booking widgets, intake PDFs and video.
- Ask your vendors (website, forms, booking, chat) how their tools support accessibility, and verify the answers.
- Review any clinical decision support tools your practice uses for protected-characteristic inputs.
- Recheck HHS and the Federal Register for new court orders or rule changes at least quarterly.
Your site also has HIPAA duties; see HIPAA compliant websites. Our free marketing audit gives an outside view of your website, SEO and Google listing; it isn't a legal or accessibility review. For the technical side, see website speed optimization.
This is general information, not legal advice. Confirm how it applies to your practice with a qualified advisor.
Frequently asked questions
Does Section 1557 apply to my practice?
It applies to health programs and activities that receive federal financial assistance, and the 2024 rule names physician practices as health programs. HHS also finalized its view in 2024 that Medicare Part B payments count as federal financial assistance, so a practice that bills Medicare Part B, Medicaid or other federal programs is likely covered. A purely cash-pay practice with no federal funding may not be; confirm with counsel.
Does Section 1557 require an accessible website?
Yes, for covered entities. The rule requires health programs offered through information and communication technology, which it defines to include websites and electronic documents, to be accessible to people with disabilities. For recipients of federal funds, websites must meet Section 504, and HHS's Section 504 rule sets WCAG 2.1 Level AA, with compliance from May 11, 2027 or May 10, 2028 depending on employee count.
What notices does Section 1557 require on a practice website?
Two, if you are covered and have a website. A notice of nondiscrimination at a conspicuous location on the site, covering your nondiscrimination policy, free language help and auxiliary aids, how to request them and how to file a complaint. And a notice that free language assistance is available, in English and at least the 15 languages most commonly spoken by people with limited English proficiency in your state.