If your practice accepts Medicare or Medicaid payments, Section 504 of the Rehabilitation Act will likely apply to you. In 2024, the Department of Health and Human Services (HHS) finalized regulations establishing new accessibility requirements for healthcare providers receiving federal financial assistance. While HHS has now extended the deadlines for website and mobile application accessibility, other provisions—including requirements related to medical decision-making and accessible medical diagnostic equipment (MDE)—remain in effect. The summary below outlines the key requirements and compliance timelines most relevant to allergy practices.
Allergy practices will now have additional time to comply with certain accessibility standards under Section 504 of the Rehabilitation Act of 1973 (Section 504). In 2024, the Department of Health and Human Services (HHS) issued a final rule under Section 504 designed to prevent disability-based discrimination in programs and activities receiving federal financial assistance, including Medicare and Medicaid. As a result, allergists and other healthcare practitioners that accept Medicaid and Medicare payments – including Medicare Part B reimbursements – must comply with Section 504, which:
- Clarifies standards for accessibility that apply to mobile applications, websites, and kiosks.
- Prohibits discrimination in decisions concerning medical treatment.
- Establishes standards for accessible medical diagnostic equipment (MDE) that are enforceable.
However, HHS recently announced a one-year extension of the compliance deadlines for the requirements for web content and mobile application accessibility:
- Allergy practices with fewer than 15 employees will now have until May 10, 2028, to comply.
- Allergy practices with 15 or more employees will now have until May 11, 2027, to comply.
Please note that this extension does not apply to other requirements outlined in the 2024 final rule, including decisions concerning medical treatment and accessible MDE.
Below are the key provisions of the final rule and their application to allergists that receive federal financial assistance.
Mobile applications, websites, and kiosks: Allergists who receive federal financial assistance must implement the Web Content Accessibility Guidelines (WCAG) 2.1 Level AA standard for mobile app accessibility and web content. Compliance with WCAG 2.1 Level AA focuses particularly on accessibility features for individuals with cognitive disabilities, learning disabilities, manual dexterity disabilities, and low vision.
If one of the five exceptions listed below applies, allergists don’t need to comply with the WCAG 2.1 Level AA standard for that specific exception. The final rule creates exceptions for:
- Archived web content.
- Pre-existing conventional electronic documents.
- Content posted by a third party – unless such documents are currently used by members of the public to apply for, gain access to, or participate in a recipient’s programs or activities.
- Individualized, password-protected, or otherwise secured documents, and pre-existing social media posts.
In addition, practices are not required to comply with the WCAG 2.1 Level AA standard if they can demonstrate that compliance would result in a fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens. Practices must document in writing why they cannot comply due to program/activity alterations or financial/administrative burdens.
With respect to kiosks, if a kiosk has inaccessible features, allergists must provide an alternative means for individuals with disabilities to access services. For instance, if an allergist uses an inaccessible kiosk to facilitate patient appointment check-ins, they must ensure that an alternative means of appointment check-in is available for patients with disabilities. Kiosks that do not rely on a website or mobile application to function are not required to implement WCAG 2.1 Level AA standards.
Compliance deadline: May 10, 2028, for recipients with less than fifteen employees; and May 11, 2027, for recipients with more than fifteen employees.
Decisions concerning medical treatment: The final rule prohibits medical practitioners, including allergists, from discriminating against people with disabilities when making medical treatment decisions. Specifically, an allergist’s decision to treat cannot be based on:
- Bias or stereotypes about a patient’s disability.
- Judgments that an individual will be a burden on others due to their disability.
- A belief that the life of a person with a disability has a lesser value than that of a person without a disability.
Nothing in the final rule requires allergists to provide treatment if:
- They have a nondiscriminatory and legitimate reason for limiting or denying a particular service.
OR - The disability disqualifies an individual from a particular form of treatment.
Compliance deadline: May 11, 2026, for recipients with more than fifteen employees; and May 10, 2027, for recipients with less than fifteen employees.
Standards for medical diagnostic equipment (MDE): Allergists that receive federal financial assistance must not turn patients away for the sole reason that their facilities lack accessible MDE. MDE includes instruments such as exam tables, blood pressure cuffs, pulse oximeters, and weigh scales. To facilitate this goal, allergists are required to work toward ensuring that at least 10% of their MDE – but not less than one unit of each type of MDE – is accessible as defined by the U.S. Access Board’s Standards for Accessible MDE. Any new piece of MDE purchased or leased after July 8, 2024, must be accessible until the 10% threshold is met. Additionally, allergists with examination tables and/or weight scales must acquire at least one accessible version of each by July 8, 2026.
There is not an exception for small practices. Rather, noncompliance is only permissible if the allergist can demonstrate that compliance would result in a fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens. Practices must document in writing why they cannot comply due to program/activity alterations or financial/administrative burdens.
The Advocacy Council – ADVOCATING FOR ALLERGISTS AND THEIR PATIENTS.
Reporting on Section 504 of the Rehabilitation Act of 1973 is for informational and educational purposes only and does not constitute medical or legal advice and is not a substitute for the exercise of a user’s own independent professional judgement.
