As per the Affordable Care Act (ACA) Section 1557, all federally-funded programs and activities should prohibit discrimination on the basis of race, color, national origin, sex, age or disability. This applies to healthcare providers that are funded by Medicare as well. The aim behind this section is to ensure that people have access to quality and affordable healthcare irrespective of their background.
However, not all Medicare programs are covered under ACA Section 1557. In this article, we will discuss which Medicare programs come under this section and what protections they provide.
Medicare Advantage Plans
Medicare Advantage Plans or Part C plans offer an alternative way for beneficiaries to receive their Medicare benefits through private health insurance companies. These insurers are required to comply with ACA Section 1557 guidelines while providing care to their members.
This means that a beneficiary cannot be denied coverage based on any discriminatory grounds mentioned above. Additionally, insurers have an obligation under this law to make reasonable accommodations so that patients with disabilities can also access and benefit from their care services.
Part D Prescription Drug Coverage
The Part D prescription drug program provides beneficiaries with prescription medication coverage through private insurance companies approved by the Centers for Medicare & Medicaid Services (CMS). Since these drug plans must comply with federal anti-discrimination laws such as Title VI of the Civil Rights Act of 1964 and Section 504 of the Rehabilitation Act of 1973), they fall under ACA’s reach too.
It means Part D plans cannot discriminate against a member based on protected characteristics like race or gender identity when offering drugs or pharmacy services covered in their policies.
Original Fee-For-Service Program
Traditional Original Fee-for-service program along with its related sub-programs: Parts A (hospitalization), B (medical service fees) gets funding support from CMS through taxpayer revenues.With regards to discrimination legislation compliance over payment reimbursement provided through these schemes falls within ACA’s purview too.While it’s provision covers only grants and credits provided to application through the enrolment stage. It aims to prevent unlawful discrimination against Essential Access providers.
End-Stage Renal Disease (ESRD) Patients
If an individual has ESRD, irrespective of the age criteria they may be eligible for assistance available through Medicare’s full range of measures.The ACA Section 1557 applies ‘only’ in cases where a vendor gets administrative support via CMS only.To quote more clinically this entails situations such as: Federally qualified health centers, Rural health clinics and Hospice Unit facilities. During their care period, beneficiaries are ensured guarantees of non-discrimination laws without any biasness about race disability or language used by them.
Conclusion:
All Medicare programs covered under ACA Section 1557 encourage accessibility to healthcare services on grounds free from partiality towards protected characteristics including gender identities or disabilities. Members can complain if they think an agency has breached the prohibitions provided in this legislation and ask for proper enforcement of non-discriminatory policies. With time we hope that more segments will come under its regulatory provisions ensuring equal healthcare opportunities regardless of one’s background.
The Affordable Care Act (ACA), also known as Obamacare, was signed into law by President Obama on March 23, 2010. The law aimed to provide quality and affordable healthcare to all Americans, regardless of their social or economic background. Under the ACA Section 1557, all federally-funded programs and activities were required to prohibit discrimination on the basis of race, color, national origin, sex, age or disability. This provision not only applies to healthcare providers but also mandates compliance from any entity that receives funding through Medicare.
The aim behind this section is to ensure people have access to quality and affordable healthcare irrespective of their background. However, not all Medicare programs are covered under ACA Section 1557. In this article, we will delve into which Medicare programs come under this section and what protections they provide.
Medicare Advantage Plans
Medicare Advantage Plans or Part C plans offer an alternative way for beneficiaries to receive their Medicare benefits through private health insurance companies. These insurers are required to comply with ACA Section 1557 guidelines while providing care services to their members.
This means a beneficiary cannot be denied coverage based on any discriminatory grounds mentioned above such as race or gender identity when offering medical care facilities included in their policies. Additionally, insurers have an obligation under this law to make reasonable accommodations so that patients with disabilities can also access and benefit from these services without any hindrances.
Part D Prescription Drug Coverage
The Part D prescription drug program provides beneficiaries with prescription medication coverage through private insurance companies approved by the Centers for Medicare & Medicaid Services (CMS). Since these drug plans must comply with federal anti-discrimination laws such as Title VI of the Civil Rights Act of 1964 and Section 504 of the Rehabilitation Act of 1973), they fall within ACA’s ambit too.
It means Part D plans cannot discriminate against a member based on protected characteristics like race or gender identity when offering drugs or pharmacy services covered in their policies. Such discrimination can lead to claims being filed at the Department of Health and Human Services (HHS).
Original Fee-For-Service Program
One of the oldest healthcare programs, Original Fee-for-service program along with its related sub-programs (Parts A – hospitalization services) and B (medical service fees), gets funding support from CMS through taxpayer revenues.
With regards to combating discrimination in payment reimbursement cases provided via these schemes falls under ACA’s purview too as it brings such grants and credits extended during enrolment stage within the scope of this law.Moreover preventive measures are being taken against discriminatory practices by essential-access providers.
End-Stage Renal Disease (ESRD) Patients
Individuals who suffer from End-stage renal disease, regardless of their age criteria may be eligible for assistance available through Medicare’s full range of services. The ACA Section 1557 applies ‘only’ in cases where a vendor gets administrative support through CMS only which includes: Federally qualified health centers, Rural health clinics, Hospice Unit facilities etc.
During treatment period beneficiaries are ensured protections under non-discrimination laws without any biases about race disability or language used by them.
Conclusion:
All Medicare programs covered under ACA Section 1557 have made considerable efforts towards promoting accessibility towards less privileged people ensuring provision for equal healthcare opportunities regardless of one’s background including protected characteristics like gender identities or disabilities. Members can file a complaint if they think an agency is breaching this legislation mandates and ask for proper enforcement on non-discriminatory policies.A more comprehensive regulatory framework supporting patient interests would be impactful in delivering effective universal healthcare goals via Medicaid too.