Final Rule Update to Section 504 of Rehabilitation Act of 1973 Strengthens Protections Against Discrimination on the Basis of Disability

Overview of Section 504

On May 9, 2024, the Department of Health and Human Services (HHS) issued a final rule to amend and update Section 504 of the Rehabilitation Act of 1973 (Section 504), strengthening protections for people with disabilities in health care programs. Section 504 prohibits any health care program or activity receiving federal financial assistance from discriminating against individuals on the basis of disability and is enforced by the Office of Civil Rights in HHS. The final rule went into effect as of July 8, 2024.

(This rule update comes a few days after HHS published Section 1557 Final Rule of the Patient Protection and Affordable Care Act, which strengthens nondiscrimination protections in healthcare for protected classes. A brief summary of the Section 1557 Final Rule can be found here.)

Final Rule and Changes

HHS provides for broader interpretations of Section 504 to favor expansive coverage for disability protection. The final rule updates the language of Section 504 to be read consistently with other developments in disability protection, including title II of the  Americans with Disabilities Act (ADA), a civil rights law that prohibits discrimination on the basis of disability. Changes to Section 504 address several important areas: medical treatment, value assessment methods, child welfare programs and activities, web, mobile, and kiosk accessibility, and accessible medical equipment.

Medical treatment. Recipients may not deny or limit medical treatment to an individual with a disability for reasons based on derogatory attitudes or prejudiced beliefs, a belief that the individual’s disability is burden on others, or a belief that the individual’s life is less valuable than other people without a disability.

Value assessment methods. Recipients cannot directly or indirectly use any measure, assessment or tool that discounts the value of an individual’s life extension on the basis of disability to deny or otherwise affect their access to any aid, benefit, or service.

Child welfare programs and activities. Nondiscrimination prohibitions on the basis of disability extend to the participation or access to benefits and services provided by child welfare programs and activities. These include family preservation and reunification services and parent-child visitation rights.

Web, mobile, and kiosk accessibility. Programs and services provided through kiosks must also comply with the nondiscrimination requirement. Website content and mobile applications recipients make available directly or indirectly must be accessible to individuals with disabilities and must comply with technical web accessibility guidelines.

Accessible medical equipment. Recipients’ medical diagnostic equipment (MDE) must meet the Access Board’s Standards for Accessible MDE. The rule addresses newly purchased equipment, standards for examination tables and weight scales, and program accessibility with existing MDE.

For consistency, the final rule also incorporates similar or exact provisions from the ADA related to: illegal use of drugs, maintenance of accessible features, retaliation or coercion against individuals, personal devices and services, service animals, mobility devices, individuals who pose a direct threat, and communication methods. The rule also clarifies the requirements for integrated settings for programs and services.

HHS does not require action that would result in a fundamental alteration in the nature of the program or service or pose undue financial or administrative burdens. However, recipients have the burden of proof to demonstrate why full compliance would be difficult in their specific circumstance.

Need Help with Existing Policies?

Recipients of federal financial assistance whose programs and activities involve individuals with disabilities should seek legal counsel with any concerns. The attorneys at Goodman Allen Donnelly ‘s Williamsburg office, Peter Mellette, Harrison Gibbs, Elizabeth Coleman are ready to assist with questions about the Final Rule and work with you to ensure your entity is in compliance with these changes. For more information, please contact Goodman Allen Donnelly’s Williamsburg office at 757-259-9200 or ecoleman@goodmanallen.com.

We acknowledge with appreciation Angelina Han (W&M Law Class of ‘2026) for her assistance in preparing this article.