Form Hhs-699 - Discrimination Complaint - Department Of Health And Human Services - Office For Civil Rights (Ocr) Page 4
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13health insurance Marketplaces from discriminating against individuals living with disabilities,
including HIV. As elucidated by the anti-discrimination regulations implementing Section 1557
(the Anti-Discrimination Regulations), this anti-discrimination mandate reaches those insurers
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operating through a federal- or state-established health insurance Marketplace.
The U.S. Department of Health and Human Service (HHS) Office for Civil Rights (OCR) has
primary responsibility for ensuring compliance with Section 1557 through investigations and
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enforcement actions.
Under 45 C.F.R. § 85.61(d), OCR is required to “accept and investigate all
complete complaints for which it has jurisdiction.” 45 C.F.R. § 92.301 additionally provides that
“[t]he enforcement mechanisms available for and provided under Title VI of the Civil Rights Act
of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of
1973, or the Age Discrimination Act of 1975 shall apply for purposes of Section 1557.”
Noncompliance can result in suspension, termination, or refusal to grant or continue federal
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financial assistance.
OCR has primary oversight over Section 1557, although the Department of
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Justice (DOJ) has coordinating responsibility pursuant to Executive Order 12250.
UPMC offers
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Qualified Health Plans (QHPs)
on Pennsylvania’s federally-facilitated Marketplace and is
therefore subject to OCR jurisdiction.
IV.
PRELIMINARY STATEMENT
Under the ACA, health insurers may not discriminate on the basis of disability. Section 1557 and
other ACA provisions prohibit discriminatory health insurance practices, including plan benefit
designs which discourage enrollment of persons with significant health needs, including people
living with HIV.
th
Approximately 35,000 people in Pennsylvania are living with HIV, with the state ranking 10
in
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the nation in the number of new HIV diagnoses per year.
Due to the complexities and rapid
evolution in HIV treatment standards, HHS maintains a document called Guidelines for the Use
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80 Fed. Reg. 54172, 54173 (Sept. 8, 2015).
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Id. at 54172-221.
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81 Fed. Reg. 31376-01, 31440 (May 18, 2016) (“OCR is responsible for enforcement with respect to benefit design
issues under Section 1557.”).
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See, e.g., 45 C.F.R. §§ 80.8, 84.6, and 302(c).
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Exec. Order No. 12,250, 3 C.F.R. § 298 (1980).
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UPMC’s silver-level QHPs include: UPMC Health Plan Advantage Silver $0/$50 – Partner Network, UPMC Health
Plan Advantage Silver $0/$50–Premium Network, UPMC Health Plan Advantage Silver $0/$50–Select Network,
UPMC Health Plan Advantage Silver $1750/$30–Partner Network, UPMC Health Plan Advantage Silver $1750/$30–
Premium Network, UPMC Health Plan Advantage Silver $1750/$30–Select Network, UPMC Health Plan Advantage
Silver $3250/$10–Partner Network, UPMC Health Plan Advantage Silver $3250/$10 – Premium Network, UPMC
Health Plan Advantage Silver $3250/$10–Select Network, UPMC Health Plan Advantage Silver HSA $2600/20%–
Partner Network, UPMC Health Plan Advantage Silver HSA $2600/20%–Premium Network, and UPMC Health Plan
Advantage Silver HSA $2600/20%–Select Network.
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Bureau of Epidemiology, Pennsylvania Department of Health. “Annual HIV Surveillance Summary,” (2015)
available at
H/HIV%20And%20AIDS%20Epidemiology/Documents/2015%20Annual%20HIV%20Surveillance%20Summary%
20Report.pdf.
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Centers for Disease Control and Prevention. “Pennsylvania – 2015 State Health Profile.” (2015) available at
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