Questions and Answers
As a result of violations of ACA Section 1557 nondiscrimination rules, what may happen to a health plan?
Under ACA Section 1557, a health plan may charge higher premiums based on what?
An individual's age
What do ACA Section 1557 rules for disability concern?
Policies and procedures, physical access, and communication
What best describes Section 1557 of the Affordable Care Act (ACA)?
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Which Medicare programs are covered by ACA Section 1557?
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Study Notes
Section 1557 Overview
- Section 1557 of the ACA prohibits discrimination in health care based on race, color, national origin, disability, age, and sex.
- It integrates existing civil rights protections applicable to federally funded health programs and those administered by HHS.
Consequences of Violations
- Violations of Section 1557 can lead to revocation of an agent or broker's appointment with a health plan.
- Health plans may face termination from federally funded lines of business, such as Medicare, and may be required to pay compensatory damages.
Premium Charges Based on Age
- Under Section 1557, health plans sold through state exchanges cannot charge higher premiums based solely on an individual's age.
- There is a general prohibition against excluding or limiting benefits and services based on age, including primary care services.
Disability Access Compliance
- Covered entities must implement policies ensuring equal access for individuals with disabilities.
- This entails making adjustments in policies and practices, ensuring physical accessibility in facilities, and providing effective communication for individuals with disabilities and their companions.
Medicare Coverage Under Section 1557
- ACA Section 1557 covers Medicare Parts A, C, and D but excludes Part B.
- Federal financial assistance, which activates compliance with Section 1557, includes grants, property, Medicaid, and certain Medicare payments, excluding Part B payments to physicians.
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Description
This quiz focuses on the regulations and consequences of ACA Section 1557 nondiscrimination rules in health plans. Understand the implications and responsibilities that health plans and agents have under this important legislation.
