Section 1557 Final Rule Pre-Publication

8/17/2019 Section 1557 Final Rule Pre-Publication

1/361

http://federalregister.gov/a/2016-11458.pdfhttp://federalregister.gov/a/2016-11458


2/361


3/361


4/361


5/361


6/361


7/361


8/361


9/361


10/361


11/361


12/361


13/361


14/361


15/361


16/361


17/361


18/361


19/361


20/361


21/361


22/361


23/361


24/361


25/361


26/361


27/361


28/361


29/361


30/361


31/361


32/361


33/361


34/361


35/361


36/361


37/361


38/361

http://www.who.int/about/definition/en/print.html


39/361


40/361


41/361

http://www.lep.gov/faqs/faqs.html#OneQ11


42/361


43/361

https://www.justice.gov/sites/default/files/crt/legacy/2011/05/04/090810_AAG_Perez_Letter_to_Ed_OCR_Title%20VI_and_Religiously_Identifiable_Groups.pdfhttps://www.justice.gov/sites/default/files/crt/legacy/2011/05/04/090810_AAG_Perez_Letter_to_Ed_OCR_Title%20VI_and_Religiously_Identifiable_Groups.pdf


44/361

http://www.westlaw.com/Link/Document/FullText?findType=L&pubNum=1000547&cite=45CFRS86.40&originatingDoc=I9EF35B6055F711E5902ADDEBA8547597&refType=RB&originationContext=document&vr=3.0&rs=cblt1.0&transitionType=DocumentItem&contextData=(sc.UserEnteredCitation)#co_pp_a83b000018c76http://www.hhs.gov/sites/default/files/ocr/civilrights/activities/agreements/Arizona/vra.pdf


45/361

https://www.nachc.com/client/OCRLetterJuly2012.pdfhttp://www2.ed.gov/about/offices/list/ocr/docs/qa-201404-title-ix.pdfhttp://www2.ed.gov/about/offices/list/ocr/docs/qa-201404-title-ix.pdfhttps://www.justice.gov/opa/pr/attorney-general-holder-directs-department-include-gender-identity-under-sex-discriminationhttps://www.justice.gov/opa/pr/attorney-general-holder-directs-department-include-gender-identity-under-sex-discriminationhttps://www.justice.gov/sites/default/files/crt/legacy/2015/02/27/tooleysoi.pdfhttps://www.justice.gov/sites/default/files/crt/legacy/2015/02/27/jamalsoi.pdfhttp://www.dol.gov/ofccp/regs/compliance/directives/dir2014_02.html


46/361

http://www.eeoc.gov/decisions/0120133080.txt


47/361


48/361


49/361


50/361


51/361

http://www.medicare.gov/sign-up-change-plans/same-sex-marriage.html


52/361


53/361



54/361


55/361


56/361

http://www.hhs.gov/civil-rights/for-providers/compliance-enforcement/examples/limited-english-proficiency/MCDSS-resolution-agreement/index.htmlhttp://www.hhs.gov/civil-rights/for-providers/compliance-enforcement/examples/limited-english-proficiency/MCDSS-resolution-agreement/index.html


57/361


58/361


59/361

http://www.imiaweb.org/uploads/pages/438.pdf


60/361


61/361


62/361


63/361


64/361


65/361


66/361


67/361


68/361


69/361


70/361


71/361


72/361


73/361


74/361


75/361


76/361


77/361


78/361


79/361


80/361


81/361


82/361


83/361


84/361


85/361


86/361


87/361

http://www.census.gov/data/tables/2013/demo/2009-2013-lang-tables.html


88/361


89/361

http://itio-bos-fs01.itsc.hhs-itsc.local/Monika.Rushford$/1557/Detail/New%20folder/2016-05-3%20%20noon.1557%20mr%2063-130%20Revised%20Final%20Rule.doc


90/361

http://content.govdelivery.com/accounts/USCENSUS/bulletins/eeb4afhttp://www.census.gov/programs-surveys/acs/guidance/estimates.html


91/361


92/361


93/361

https://www.cms.gov/Medicare/Health-Plans/ManagedCareMarketing/FinalPartCMarketingGuidelines.html


94/361


95/361


96/361

https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/Final-2017-Letter-to-Issuers-2-29-16.pdfhttps://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/Final-2017-Letter-to-Issuers-2-29-16.pdf


97/361


98/361


99/361


100/361


101/361


102/361


103/361


104/361


105/361


106/361


107/361


108/361


109/361


110/361

http://www2.ed.gov/about/offices/list/ocr/docs/qa-201404-title-ix.pdf


111/361

http://www.hhs.gov/civil-rights/for-individuals/special-topics/national-origin/tri-agency/index.htmlhttp://www.hhs.gov/civil-rights/for-individuals/special-topics/national-origin/tri-agency/index.html


112/361


113/361

http://www.acf.hhs.gov/programs/occ/law/guidance/current/pi0004/pi0004.htmhttp://www.acf.hhs.gov/programs/ocs/resource/liheap-im-hhs-guidance-on-the-use-of-social-security-numbers-ssns-and-citizenship-status-verificationhttp://www.acf.hhs.gov/programs/ocs/resource/liheap-im-hhs-guidance-on-the-use-of-social-security-numbers-ssns-and-citizenship-status-verification


114/361


115/361


116/361

http://www.ada.gov/olmstead/q&a_olmstead.htmhttps://www.medicaid.gov/medicaid-chip-program-information/by-topics/delivery-systems/downloads/1115-and-1915b-mltss-guidance.pdfhttps://www.medicaid.gov/medicaid-chip-program-information/by-topics/delivery-systems/downloads/1115-and-1915b-mltss-guidance.pdf


117/361


118/361


119/361


120/361


121/361


122/361


123/361



124/361


125/361


126/361

http://www.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/2014chartbooks/personcentered/personcenteredcare-chartbook.pdfhttp://www.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/2014chartbooks/personcentered/personcenteredcare-chartbook.pdf


127/361


128/361


129/361


130/361


131/361


132/361


133/361


134/361


135/361

http://www.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/2014chartbooks/hispanichealth/2014nhqdr-hispanichealth.pdfhttp://www.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/2014chartbooks/hispanichealth/2014nhqdr-hispanichealth.pdf


136/361

http://minorityhealth.hhs.gov/npa/files/Plans/NSS/NSS_07_Section3.pdf


137/361

http://www.medicaid.gov/Federal-Policy-Guidance/downloads/07-09-2010-CHIPRA-and-ACA.pdfhttp://www.medicaid.gov/Federal-Policy-Guidance/downloads/SHO10007.pdfhttp://www.kyha.com/CM/Initiatives/Safety_and_Quality_Resources/Effective_Communication_in_Hospitals.aspxhttp://www.hca.wa.gov/medicaid/interpreterservices


138/361


139/361


140/361


141/361

http://www.hhs.gov/sites/default/files/ocr/civilrights/clearance/ocr_mctap.pdfhttps://www.justice.gov/crt/about/cor/AG_021711_EO_13166_Memo_to_Agencies_with_Supplement.pdf


142/361

http://www.lep.gov/http://www.lep.gov/resources/2011_Language_Access_Assessment_and_Planning_Tool.pdfhttp://www.hhs.gov/sites/default/files/open/pres-actions/2013-hhs-language-access-plan.pdf


143/361


144/361


145/361


146/361

http://www.ncihc.org/assets/documents/publications/NCIHC%20National%20Code%20of%20Ethics.pdf


147/361

http://minorityhealth.hhs.gov/omh/browse.aspx?lvl=2&lvlid=53


148/361

http://www.migrationpolicy.org/programs/language-access-translation-and-interpretation-policies-and-practices/practitioners-corner-draftinghttp://www.migrationpolicy.org/programs/language-access-translation-and-interpretation-policies-and-practices/practitioners-corner-draftinghttp://www.migrationpolicy.org/programs/language-access-translation-and-interpretation-policies-and-practices/practitioners-cornerhttp://www.migrationpolicy.org/programs/language-access-translation-and-interpretation-policies-and-practices/practitioners-cornerhttp://www2.ed.gov/about/offices/list/ocr/letters/colleague-el-201501.pdfhttps://www.effectivehealthcare.ahrq.gov/ehc/products/329/1386/Methods_Paper-Google-Translate_1-17-13.pdfhttps://www.effectivehealthcare.ahrq.gov/ehc/products/329/1386/Methods_Paper-Google-Translate_1-17-13.pdfhttp://www.migrationpolicy.org/research/communicating-more-less-using-translation-and-interpretation-technology-LEPhttp://www.migrationpolicy.org/research/communicating-more-less-using-translation-and-interpretation-technology-LEP


149/361


150/361


151/361

http://www.hhs.gov/sites/default/files/ocr/civilrights/activities/agreements/ridhhsagreement.pdf


152/361


153/361


154/361


155/361

http://www.hhs.gov/sites/default/files/ocr/civilrights/activities/agreements/mhs_vra.pdf


156/361


157/361


158/361


159/361


160/361


161/361


162/361


163/361


164/361


165/361


166/361


167/361


168/361


169/361


170/361


171/361


172/361


173/361

https://adata.org/national-networkhttps://adata.org/


174/361


175/361


176/361


177/361


178/361


179/361


180/361


181/361


182/361


183/361


184/361


185/361


186/361


187/361


188/361


189/361


190/361


191/361


192/361


193/361


194/361


195/361

https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-09-01.htmlhttps://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-09-01.htmlhttp://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/aca_implementation_faqs5.html


196/361

https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/aca_implementation_faqs2.htmlhttps://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/aca_implementation_faqs2.html


197/361


198/361


199/361


200/361


201/361


202/361


203/361


204/361


205/361


206/361


207/361


208/361


209/361


210/361


211/361


212/361


213/361


214/361

http://www.hhs.gov/dab/decisions/dabdecisions/dab2576.pdfhttp://www.nationalacademies.org/hmd/Reports/2011/The-Health-of-Lesbian-Gay-Bisexual-and-Transgender-People.aspxhttp://www.nationalacademies.org/hmd/Reports/2011/The-Health-of-Lesbian-Gay-Bisexual-and-Transgender-People.aspx


215/361


216/361


217/361


218/361

https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c32.pdf


219/361


220/361


221/361


222/361


223/361


224/361


225/361


226/361


227/361


228/361

http://www.eeoc.gov/facts/association_ada.htmlhttp://www.eeoc.gov/facts/association_ada.html


229/361


230/361


231/361


232/361


233/361


234/361


235/361


236/361


237/361


238/361


239/361

http://www.westlaw.com/Link/Document/FullText?findType=L&pubNum=1000547&cite=45CFRS85.62&originatingDoc=I9EF35B6055F711E5902ADDEBA8547597&refType=LQ&originationContext=document&vr=3.0&rs=cblt1.0&transitionType=DocumentItem&contextData=(sc.UserEnteredCitation)http://www.westlaw.com/Link/Document/FullText?findType=L&pubNum=1000547&cite=45CFRS85.61&originatingDoc=I9EF35B6055F711E5902ADDEBA8547597&refType=LQ&originationContext=document&vr=3.0&rs=cblt1.0&transitionType=DocumentItem&contextData=(sc.UserEnteredCitation)


240/361

http://www.westlaw.com/Link/Document/FullText?findType=L&pubNum=1000547&cite=5CFRS1320.3&originatingDoc=I9EF35B6055F711E5902ADDEBA8547597&refType=RB&originationContext=document&vr=3.0&rs=cblt1.0&transitionType=DocumentItem&contextData=(sc.UserEnteredCitation)#co_pp_4b24000003ba5http://www.westlaw.com/Link/Document/FullText?findType=L&pubNum=1000546&cite=44USCAS3501&originatingDoc=I9EF35B6055F711E5902ADDEBA8547597&refType=LQ&originationContext=document&vr=3.0&rs=cblt1.0&transitionType=DocumentItem&contextData=(sc.UserEnteredCitation)


241/361


242/361

http://www.westlaw.com/Link/Document/FullText?findType=L&pubNum=1000547&cite=45CFRS80.4&originatingDoc=I9EF35B6055F711E5902ADDEBA8547597&refType=RB&originationContext=document&vr=3.0&rs=cblt1.0&transitionType=DocumentItem&contextData=(sc.UserEnteredCitation)#co_pp_8b3b0000958a4


243/361


244/361


245/361


246/361


247/361


248/361


249/361

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2526181/http://www.urban.org/sites/default/files/alfresco/publication-pdfs/411962-Estimating-the-Cost-of-Racial-and-Ethnic-Health-Disparities.PDFhttp://www.urban.org/sites/default/files/alfresco/publication-pdfs/411962-Estimating-the-Cost-of-Racial-and-Ethnic-Health-Disparities.PDFhttp://hospitals.unm.edu/dei/documents/eval_cause_conse_apha.pdf


250/361


251/361

https://www.cms.gov/Research-Statistics-Data-and-Systems/Files-for-Order/NonIdentifiableDataFiles/ProviderofServicesFile.htmlhttps://www.cms.gov/Research-Statistics-Data-and-Systems/Files-for-Order/NonIdentifiableDataFiles/ProviderofServicesFile.html


252/361

http://www.hrsa.gov/about/budget/budgetjustification2016.pdf


253/361

https://data.healthcare.gov/dataset/2015-QHP-Landscape-Individual-Market-Medical/mp8z-jtg7


254/361

https://www.fsmb.org/Media/Default/PDF/Census/census.pdfhttp://kff.org/health-reform/report/report-and-briefing-on-medicaid-coverage-and/


255/361


256/361


257/361

http://www.bls.gov/oes/2014/may/oes_nat.htmhttp://www.census.gov/econ/susb/


258/361


259/361


260/361


261/361

http://www.bls.gov/oes/2014/may/oes_nat.htm


262/361


263/361


264/361

http://www.census.gov/econ/susb/


265/361

https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2015-Press-releases-items/2015-09-02.htmlhttps://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2015-Press-releases-items/2015-09-02.html


266/361

http://medicaiddirectors.org/wp-content/uploads/2015/11/namd_4th_annual_operations_survey_report_-_november_2_2015.pdfhttp://medicaiddirectors.org/wp-content/uploads/2015/11/namd_4th_annual_operations_survey_report_-_november_2_2015.pdfhttp://www.census.gov/govs/apes/


267/361

http://ahrf.hrsa.gov/http://www.bls.gov/oes/2014/may/oes_nat.htm


268/361


269/361


270/361


271/361


272/361


273/361


274/361


275/361


276/361


277/361

http://www.census.gov/govs/apes/


278/361


279/361


280/361


281/361


282/361


283/361


284/361


285/361


286/361


287/361


288/361


289/361


290/361


291/361

http://www.lambdalegal.org/publications/when-health-care-isnt-caringhttp://www.hhs.gov/healthcare/facts-and-features/fact-sheets/women-and-aca/index.htmlhttps://aspe.hhs.gov/pdf-report/affordable-care-act-advancing-health-women-and-childrenhttps://aspe.hhs.gov/pdf-report/affordable-care-act-advancing-health-women-and-children


292/361

http://www.westlaw.com/Link/Document/FullText?findType=L&pubNum=1000547&cite=45CFRS156.125&originatingDoc=I9EF35B6055F711E5902ADDEBA8547597&refType=RE&originationContext=document&vr=3.0&rs=cblt1.0&transitionType=DocumentItem&contextData=(sc.UserEnteredCitation)#co_pp_a83b000018c76http://www.westlaw.com/Link/Document/FullText?findType=L&pubNum=1000547&cite=45CFRS156.125&originatingDoc=I9EF35B6055F711E5902ADDEBA8547597&refType=RB&originationContext=document&vr=3.0&rs=cblt1.0&transitionType=DocumentItem&contextData=(sc.UserEnteredCitation)#co_pp_8b3b0000958a4http://www.westlaw.com/Link/Document/FullText?findType=L&pubNum=1000547&cite=45CFRS156.200&originatingDoc=I9EF35B6055F711E5902ADDEBA8547597&refType=RB&originationContext=document&vr=3.0&rs=cblt1.0&transitionType=DocumentItem&contextData=(sc.UserEnteredCitation)#co_pp_7fdd00001ca15


293/361


294/361

http://www.bls.gov/oes/2014/may/oes_nat.htmhttp://www.hrc.org/campaigns/corporate-equality-index


295/361

http://translaw.wpengine.com/wp-content/uploads/2013/04/Economic-Impact-Assessment-Gender-Nondiscrimination-In-Health-Insurance.pdfhttp://translaw.wpengine.com/wp-content/uploads/2013/04/Economic-Impact-Assessment-Gender-Nondiscrimination-In-Health-Insurance.pdf


296/361

http://williamsinstitute.law.ucla.edu/wp-content/uploads/Herman-Cost-Benefit-of-Trans-Health-Benefits-Sept-2013.pdfhttp://williamsinstitute.law.ucla.edu/wp-content/uploads/Herman-Cost-Benefit-of-Trans-Health-Benefits-Sept-2013.pdf


297/361


298/361


299/361


300/361

http://www.aha.org/research/rc/stat-studies/101207fastfacts.pdfhttp://www.aha.org/research/rc/stat-studies/101207fastfacts.pdf


301/361


302/361


303/361


304/361

https://www.justice.gov/sites/default/files/crt/legacy/2010/12/14/omb-lepreport.pdf


305/361

http://www.ahrq.gov/sites/default/files/publications/files/lepguide.pdfhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448350/https://aspe.hhs.gov/execsum/caring-immigrants-health-care-safety-nets-los-angeles-new-york-miami-and-houstonhttp://www.healthlaw.org/images/stories/High_Costs_of_Language_Barriers_in_Malpractice.pdf


306/361


307/361

http://out2enroll.org/lgbthealthcare/wp-content/uploads/2014/07/O2E_KeyLessons_FINAL.pdfhttp://www.preventionjustice.org/wp-content/uploads/2013/10/CAP-LGBT-Messaging-Research.pdfhttp://www.hrc.org/reports/heihttp://www.thetaskforce.org/


308/361

https://www.americanprogress.org/issues/lgbt/report/2014/11/17/101575/moving-the-needle/https://aspe/hhs.govhttps://www.americanprogress.org/issues/lgbt/report/2015/04/30/112169/open-doors-for-all/


309/361


310/361

https://aspe.hhs.gov/sites/default/files/pdf/77061/ib_UncompensatedCare.pdfhttps://kaiserfamilyfoundation.files.wordpress.com/2014/05/8596-uncompensated-care-for-the-uninsured-in-2013.pdfhttps://kaiserfamilyfoundation.files.wordpress.com/2014/05/8596-uncompensated-care-for-the-uninsured-in-2013.pdf


311/361


312/361


313/361


314/361


315/361


316/361


317/361


318/361


319/361

https://www.sba.gov/sites/default/files/Size5FStandards5FTable.pdf


320/361


321/361


322/361


323/361


324/361

http://www.bls.gov/iag/tgs/iag621.htm


325/361


326/361


327/361


328/361


329/361


330/361


331/361


332/361


333/361


334/361


335/361


336/361


337/361


338/361


339/361


340/361


341/361


342/361


343/361


344/361


345/361


346/361


347/361


348/361


349/361


350/361


351/361


352/361


353/361


354/361


355/361


356/361


357/361


358/361


359/361


360/361


361/361

Documents

Section 1557 Final Rule Pre-Publication