As a result of violations of ACA Section 7 nondiscrimination rules (specifically under Section 1557 of the Affordable Care Act), which prohibits discrimination based on race, color, national origin, sex, age, or disability in health programs or activities receiving federal financial assistance, several consequences may occur:
- Covered entities that receive federal funding must comply with nondiscrimination requirements and provide notices of nondiscrimination to participants, beneficiaries, or applicants.
- Violations can lead to enforcement actions by the Office for Civil Rights (OCR) within the Department of Health and Human Services (HHS), which may include investigations, requirements for corrective actions, or fund suspension or termination.
- Individuals who experience discrimination may file complaints with OCR or bring civil actions in U.S. district courts against entities that violate these rules.
- Compensatory damages may be awarded in administrative or judicial actions for violations of Section 1557.
- Entities found non-compliant may be required to make structural changes in their health programs or activities to meet nondiscrimination compliance.
- These rules cover discrimination in health coverage benefits, claims denials, benefit design, marketing practices, or cost-sharing based on protected characteristics.
In summary, violations can lead to administrative enforcement, legal actions, financial consequences, and requirements to rectify discriminatory practices under ACA Section 7 nondiscrimination rules.
