The Department of Health and Human Services (HHS) has published a final rule implementing Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in any health program or activity that receives financial assistance from or is administered by HHS or any entity created under Title I of the ACA, including qualified health plan issuers. Notably, the rule implements ACA civil rights protections against sex discrimination, including gender identity discrimination, in these health programs. The rule also establishes requirements related to effective communication for individuals with disabilities, enhanced language assistance for people with limited English proficiency, and legal remedies for discrimination. With regard to the scope of the rule, HHS explains in a guidance document that it “applies to every health program or activity that receives HHS funding, every health program or activity administered by HHS, such as the Medicare Part D program, and the Health Insurance Marketplaces and all plans offered by issuers that participate in those Marketplaces.” Likewise, entities covered by the rule “may include hospitals, health clinics, health insurance issuers, state Medicaid agencies, community health centers, physician’s practices and home health care agencies.” The rule is effective July 18, 2016, although to the extent that the rule requires changes to health insurance policies, it will apply on the first day of the first policy year beginning on or after January 1, 2017. Additional HHS resources are posted here.