45 C.F.R. § 92.1

Purpose and effective date

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(a) Purpose. The purpose of this part is to implement section 1557 of the Patient Protection and Affordable Care Act (ACA) (42 U.S.C. 18116), which prohibits discrimination on the basis of race, color, national origin, sex, age, and disability in certain health programs and activities. Section 1557 provides that, except as otherwise provided in title I of the ACA, an individual shall not, on the grounds prohibited under title VI of the Civil Rights Act of 1964, title IX of the Education Amendments of 1972, the Age Discrimination Act of 1975, or section 504 of the Rehabilitation Act of 1973, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under, any health program or activity, any part of which is receiving Federal financial assistance, including credits, subsidies, or contracts of insurance, or under any program or activity that is administered by an executive agency or any entity established under title I of the ACA. This part applies to health programs or activities administered by recipients of Federal financial assistance from the Department, Department-administered health programs or activities, and title I entities that administer health programs or activities.

(b) Effective date. The regulations in this part are effective beginning July 5, 2024, unless otherwise provided in the following schedule:

Table 1 to Paragraph (b)
Section 1557 requirement and provision	Date by which covered entities must comply
§ 92.7	Within 120 days of July 5, 2024.
§ 92.8	Within one year of July 5, 2024.
§ 92.9	Following a covered entity's implementation of the policies and procedures required by § 92.8, and no later than one year of July 5, 2024.
§ 92.10	Within 120 days of July 5, 2024.
§ 92.11	Within one year of July 5, 2024.
§ 92.207(b)(1) through (5)	For health insurance coverage or other health-related coverage that was not subject to this part as of July 5, 2024, by the first day of the first plan year (in the individual market, policy year) beginning on or after January 1, 2025.
§ 92.207(b)(6)	By the first day of the first plan year (in the individual market, policy year) beginning on or after January 1, 2025.
§ 92.210(b) and (c)	Within 300 days of July 5, 2024.

Notes of Decisions

Cited in 7 cases (3 in the last 5 years), 2015–2025 · leading case: Callum v. CVS Health Corp., 137 F. Supp. 3d 817 (D.S.C. 2015).

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Callum v. CVS Health Corp., 137 F. Supp. 3d 817 (D.S.C. 2015). · cites it 2× “at 54214-15 (to be codified at 45 C.F.R. § 92.1 ). The proposed enforcement provision states, “An individual or entity may bring a civil action to challenge a violation of Section 1557 or this part in a United States District Court in which the recipient or State-based…”

Franciscan All., Inc. v. Burwell, 227 F. Supp. 3d 660 (N.D. Tex. 2016). “45 C.F.R. § 92.1 . The ground at issue in this case is Section 1557’s incorporation of the prohibited sex discrimination under Title IX of the Education Amendments of 1972 (“Title IX”).”

Price v. Kendall (E.D. Mich. 2022). · cites it 3× “§§ 1981 , 1983, and 18116 as well as 45 C.F.R. 92.1. (ECF No. 1, PageID.9.) His claims are either legally frivolous or fail to state a claim upon which relief can be granted.”

Basta v. Novant Health, Inc. (W.D.N.C. 2019). “” 45 C.F.R. § 92.1 . (emphasis added). While courts are divided on whether the ACA provides a private right of action, one court in this Circuit has held that individuals who are denied participation in health programs or activities can bring claims under Section 1557.”

Asapansa-Johnson Walker v. Azar II (E.D.N.Y 2020). “Those include:  45 C.F.R. § 92.1 , which revises previous language, not of substantive significance, describing the purpose of the regulations dealing with implementation of § 1557’s nondiscrimination provision.”

In Re Bright Health Mgmt., Inc. v. the State of Texas (Tex. App. 2025). “45 CFR §§ 92.1 92.303. 10. Certifications to Accuracy, Completeness, and Truthfulness of Data.”

Bright Health Mgmt., Inc. v. Texas Dep't of Ins. & Cantilo & Bennett, L.L.P., Special Deputy Receiver of Bright Healthcare Ins. Co. of Texas (Tex. App. 2025). “45 CFR §§ 92.1 92.303. 10. Certifications to Accuracy, Completeness, and Truthfulness of Data.”

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