Sample Forms

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Nondiscrimination Notice

Non-Discrimination Notice

Tagline

Non-Discrimination Tagline

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Turn Everyone into a Potential Patient

NonDiscriminationSection 1557 of the Affordable Care Act was passed into law in July of 2016. This is a wide-ranging regulation that covers many aspects of discrimination in regard to the treatment of patients – we’ll cover only those aspects that affect your practice website.

Not all healthcare practices are affected by this law; only those that accept:

  • Federal financial assistance – includes grants, property, Medicaid, Medicare Parts A, C and D payments, and tax credits and cost-sharing subsidies under Title I of the ACA. (Medicare Part B is not included.)

  • All health programs and activities administered by entities created under Title I of the ACA (e.g., State-based and Federally-facilitated Health Insurance Marketplaces).

There are two documents that must be accessible from the home page of the practice’s website:

  • Notice Informing Individuals About Nondiscrimination and Accessibility Requirements.

  • Taglines, which are short statements in non-English languages, to notify the individual about the availability of language assistance services.

The only information we need from you in order to create these documents is:

  • The legal name of the practice
  • The name, title and email address of the practice’s Civil Rights Coordinator (CRC)
  • The practice’s mailing address and phone and fax number (and TTY number, if available)
  • The practice’s Translation Service phone number (and TTY number, if available)

We’ve created a simple form on our website to help in furnishing this information. Once we’ve received your information we’ll create both documents, upload them to your website and link to them from your home page. At that point your website will be fully compliant.

To make your website fully usable by viewers speaking any language, see our Multilingual Websites option.