Section 1557 website notices for practices

If your practice receives federal financial assistance from HHS, the Section 1557 rule asks it to publish two notices: a notice of nondiscrimination and a notice that language help and disability aids are available free of charge. Both have to sit in a conspicuous location on the practice website. They also go on paper in the office, and the second one, known as the taglines notice, travels with a set list of forms and letters. This guide walks through what each notice must say, where it goes on a website, which parts a federal court has vacated, and how to fit the notices into a site without burying them.

Two related topics have their own guides and are not repeated here. The wider language access duties, qualified interpreters, machine translation and ads in other languages are in our guide to Spanish-language and multilingual marketing. Making the website itself usable for people with disabilities, including the Section 504 web standard and WCAG, is in our website accessibility guide. This guide covers the two notices. For what to do when a law firm sends a letter about website accessibility, see our guide to ADA website demand letters. For how the notice fits with claims, intake forms and ad targeting for LGBTQ patients, see our guide to LGBTQ-inclusive practice marketing. How these notices fit on an office wall next to posters and screens is covered in our waiting room screens and in-office marketing guide. How Section 1557 and state law bear on choosing an ad audience is in our guide to healthcare ad targeting by age, sex, race and language. For the other documents on a practice site, such as intake packets and the Notice of Privacy Practices, see accessible PDFs and patient documents.

This is general information, not legal advice. Whether your practice is a covered entity, and how to word its notices, are questions for a health care attorney. Sources cited were checked on October 30, 2026: 45 CFR 92.1, 92.2, 92.4, 92.7, 92.8, 92.10, 92.11 and 92.204, the 2024 final rule at 89 FR 37522, the HHS notification of court decision at 91 FR 32887 (June 2, 2026), and the HHS Office for Civil Rights page on filing a civil rights complaint (content last reviewed December 12, 2025).

Who the notices apply to

Section 1557 of the Affordable Care Act bars discrimination on the basis of race, color, national origin, sex, age and disability in certain health programs and activities. Under 45 CFR 92.2, the rule applies to every health program or activity any part of which receives federal financial assistance, directly or indirectly, from HHS, to programs HHS runs, and to programs run by entities set up under title I of the ACA. A covered entity, as defined in 92.4, is a recipient of that assistance, HHS itself, or a title I entity.

Federal financial assistance is defined broadly in 92.4: any grant, loan, credit, subsidy or contract (other than a procurement contract, but including a contract of insurance) by which the federal government provides funds, the services of federal staff, or property. For independent practices, one line in the 2024 rule matters. In section III of the final rule, HHS announced a change in interpretation: it now treats funds paid through Medicare Part B to providers and suppliers as federal financial assistance, where its earlier position had been that they were not (89 FR 37664 to 37666). The June 2026 notice of court decision, discussed below, does not list that interpretation among the vacated provisions.

So a practice that bills Medicare Part B should not assume the notices are someone else’s problem. A practice that takes no federal money of any kind may fall outside the rule. Where your practice sits is a legal question, and the answer decides whether everything below is a requirement or a good habit.

Notice one: the notice of nondiscrimination

The rule for this notice is 45 CFR 92.10. It asks a covered entity to give the notice to patients, applicants and members of the public.

Paragraph (a)(1) lists eight things the notice must include about the practice’s health programs and activities. In plain words, they are:

That the practice does not discriminate on the basis of race, color, national origin (including limited English proficiency and primary language), sex, age or disability. The court decision discussed below affects part of this line.
That it provides reasonable modifications for people with disabilities, and appropriate auxiliary aids and services, such as qualified interpreters and information in alternate formats like braille or large print, free of charge and in a timely manner when they are needed.
That it provides language assistance services, including translated documents and oral interpretation, free of charge and in a timely manner when they are a reasonable step to give meaningful access to a person with limited English proficiency.
How to ask the practice for those modifications, aids and language services.
Contact information for the practice’s Section 1557 Coordinator, if it is required to have one.
That a grievance procedure is available and how to file a grievance, if the practice is required to have one.
How to file a discrimination complaint with the HHS Office for Civil Rights.
How to reach the practice’s website, if it has one, that carries this information.

Two items depend on headcount. Under 92.7(a), a covered entity that employs fifteen or more persons must designate at least one employee as its Section 1557 Coordinator. Under 92.8(c), a covered entity with fifteen or more employees must have written grievance procedures and keep grievance records for at least three calendar years after it resolves each grievance. A smaller practice still owes the rest of the notice, but the coordinator and grievance lines apply only “if applicable.”

For the complaint line, the OCR page on filing a civil rights complaint says a person may file with OCR, for themselves or someone else, and points to the online OCR Complaint Portal. Link to that page from your notice so the details stay current, and check the link when you review the notice.

Under 92.10(b), a practice may combine this notice with the notices required by other HHS civil rights rules, as long as the combined notice clearly tells people about their rights under Section 1557 and still includes every element listed above.

Notice two: the language and disability aids notice

45 CFR 92.11(a) asks for a separate, shorter notice. At minimum it states that the practice provides language assistance services and appropriate auxiliary aids and services free of charge, when necessary for compliance with Section 1557 or the rule. The notice is short; the burden is in the languages.

Under 92.11(b), this notice must be provided in English and in at least the 15 languages spoken by the largest numbers of people with limited English proficiency in the state or states where the practice operates. It must also be available in alternate formats for people with disabilities who need auxiliary aids and services. A practice with offices in two states has to account for the language lists of both.

The rule does not hand you the list of 15 languages, and we do not give one here, because it differs by state and changes with the population. Build it from current data for your state or states, record where it came from and the date, and revisit it at each annual review. Have a qualified translator produce each translation; the reasons, and the rule on machine translation, are in our multilingual marketing guide linked above.

Where the notices go

Both notices share the same placement list. Under 92.10(a)(2) and 92.11(c), each must be provided:

On an annual basis to patients and applicants of the program.
Upon request.
At a conspicuous location on the practice’s website, if it has one.
In clear and prominent physical locations, in no smaller than 20-point sans serif font, where people seeking service can reasonably be expected to read or hear it.

The taglines notice under 92.11 has one more placement rule. Under 92.11(c)(5), it goes in the following electronic and written communications when the practice provides them: the notice of nondiscrimination itself, the HIPAA notice of privacy practices, application and intake forms, notices of denial or termination of services and appeal rights, communications about a person’s rights or services that ask for a response, public health emergency communications, consent forms and procedure instructions, discharge papers, cost and payment communications including billing and collections and good faith estimates, complaint forms, and patient handbooks.

That list reaches well past the website. Your online intake forms, your good faith estimates for self-pay patients, billing emails and portal messages that ask for a reply each need a check. Promotional emails and ads do not appear on the list. An appointment or billing message might, depending on what it says, so put any doubtful template in front of counsel.

Under 92.11(d), a practice can meet the taglines duty for an individual in one of two other ways. It may offer the person, each year, the option to opt out of receiving the notice, with conditions: receipt of care cannot depend on the choice, silence does not count as opting out, the person must be told that opting out does not waive their right to language help, and the opt-out is documented each year. Or it may record the person’s primary language and needed aids, then send everything in that language and format, or include the notice in that language in every communication on the 92.11(c)(5) list. Both routes depend on records the practice keeps, so decide on one with counsel before relying on it.

What the court decision changed, and what it did not

The rule took effect on July 5, 2024, and 92.1(b) set later compliance dates: 92.10 within 120 days of July 5, 2024, and 92.11 and the 92.8 policies within one year of that date. Those dates have passed.

On June 2, 2026, HHS published a notification of court decision at 91 FR 32887. It reports that on October 22, 2025, the U.S. District Court for the Southern District of Mississippi, in Tennessee v. Kennedy, vacated a set of provisions of the 2024 rule to the extent they expand Title IX’s definition of sex discrimination to include gender identity discrimination. The vacated list includes 45 CFR 92.10(a)(1)(i), the first line of the nondiscrimination notice, and 92.8(b)(1), the matching line in the written nondiscrimination policy. The notification says OCR cannot and will not enforce the vacated provisions to that extent, and that the other provisions of the 2024 rule remain in force.

For a practice website, the practical effect is narrow. The notice of nondiscrimination is still required, and the other seven elements are untouched. The taglines notice under 92.11 is not on the vacated list. What changed is how the sex line in the first element is read. How to word that line today is a question for your attorney, and it is worth checking the Federal Register again before each annual review, since a later rule or court order could change it again.

Building the notices into the website

The rule says “conspicuous location” and leaves the design to you. We treat the notices as part of practice website design from the first draft, not as a page added at launch.

Here is how we approach it:

Give each notice its own page in plain HTML text, not a scanned image or an image-only PDF, so screen readers, translation tools and search engines can read it. The accessibility duty in 92.204 applies to health programs offered through websites too.
Link both pages from the site-wide footer with plain labels such as “Nondiscrimination notice” and “Language assistance”, so the link appears on every page.
On the language assistance page, write each tagline in its own language, marked up with the right language attribute, and put a working phone number or contact route next to it.
Make sure the contact route works in practice. If a tagline promises free interpretation by phone, the phone line has to reach someone who can arrange it.
Keep the coordinator’s name or title and contact details in one place on the site, so a staff change means one edit.
Add a review date to each page and a reminder in your calendar to recheck the languages, the contact details and the OCR link each year.

Those footer links sit alongside the other legal pages a practice site carries, such as the website privacy policy. Our practice website checklist lists the rest.

Illustration: two ways to handle the notices

Illustration: a family practice that bills Medicare Part B adds a single PDF of its nondiscrimination notice to a page called Patient Resources. The PDF is a scan of the paper sign, the taglines appear as an image, the coordinator listed left the practice last year, and the online intake form carries no taglines. A patient who reads Vietnamese and uses a screen reader cannot find or read any of it.

Illustration: the same practice puts both notices on their own HTML pages, linked from the footer of every page. The taglines appear as text in each language from its dated list, each with the number for the interpreter line, which staff have tested. The intake form, the good faith estimate template and the billing emails carry the taglines notice, the coordinator’s contact is a role address, and the pages show the date of the last review. The notice wording was checked with counsel after the June 2026 notification.

Checklist

Confirm with counsel whether the practice is a covered entity, including whether it bills Medicare Part B or receives other HHS funds.
Count employees: at fifteen or more, designate a Section 1557 Coordinator and set up written grievance procedures.
Draft the notice of nondiscrimination with all eight elements of 92.10(a)(1), and have counsel review the sex line in light of the June 2, 2026 notification.
Build the list of 15 languages for each state you operate in from current data, record the source and date, and have qualified translators produce the taglines.
Publish both notices as HTML pages linked from every page of the website.
Post both notices in the office in no smaller than 20-point sans serif font.
Add the taglines notice to intake forms, the notice of privacy practices, consent forms, billing and collections materials, good faith estimates, complaint forms and the other communications in 92.11(c)(5).
Test the contact routes the notices promise, including the interpreter line.
Review the notices, languages, contacts and links once a year and after any new rule or court order.

How we help

We build websites, local search, Google Ads and AI front desk tools for independent practices and health businesses. For Section 1557 notices, that means a website with clear, accessible notice pages linked from every page, multilingual pages that carry the right language markup, and intake flows and form templates with room for the taglines. We do not write your legal notices and we do not decide whether the rule applies to you; your attorney does. Our tools are built with HIPAA in mind. We confirm in writing what a BAA covers before any patient information flows through a tool, and if it is not covered, we do not route patient information through it. We are not a healthcare provider and we do not give legal or medical advice. We do not sell lead lists and we do not pay for referrals. For the wider rules, see our healthcare marketing rules hub.

Does every medical practice need a Section 1557 notice?

No. The rule applies to health programs and activities that receive federal financial assistance from HHS, programs HHS runs, and title I entities. In the 2024 rule, HHS said it treats Medicare Part B payments as federal financial assistance, so a practice that bills Part B should ask counsel whether it is covered.

Where on the website does the notice have to go?

The rule says a conspicuous location on the website. It does not name a spot. A plain text page linked from the footer of every page is one way to meet that, with the taglines notice on its own page or in the same place.

Which languages do the taglines need?

English plus at least the 15 languages spoken by the largest numbers of people with limited English proficiency in the state or states where the practice operates, and alternate formats for people with disabilities who need them.

Was the Section 1557 rule struck down?

Not as a whole. A federal court vacated certain provisions to the extent they expand sex discrimination to include gender identity, including the first line of the nondiscrimination notice to that extent. HHS says the other provisions remain in force.

Do our marketing emails need the taglines?

Promotional emails are not on the list in 92.11(c)(5). Intake forms, billing and collections materials, good faith estimates, consent forms and messages about a patient’s rights or services that ask for a reply are.

We have fewer than fifteen employees. What changes?

The coordinator and written grievance procedure requirements apply at fifteen or more employees. A smaller covered practice still needs both notices, the written policies and the language and disability services the notices describe.

Sources

More in Practice websites, privacy and tracking

Section 1557 website notices: the nondiscrimination notice and language taglines on a practice website