Are you a medical practice, or are you an agency with clients that are medical practices?
The new requirements
A new rule published in May 2024 that goes into effect in May 2026 affects any medical practice that receives HHS (US Dept of Health and Human Services) money. For example, if you accept Medicare or Medicaid.
The HHS put out a short fact sheet on the final rule. The Federal Register lists the full final rule, but at 130 pages you may not to read that right now.
In short, the new requirement is that your online presence conforms to WCAG 2.1 level AA.
- If your practice has 15 or more employees, conformance by May 10, 2026.
- If your practice has less than 15 employees, conformance by May 11, 2027.
- These requirements are the same as ADA Title II, so if you fall under both laws, they match.
- This affects websites, web content, PDFs, mobile apps, social media, and emails.
Who it affects
Per HHS.gov, the following are recipients of Federal financial assistance from HHS and must comply with the new rule’s requirements:
- Healthcare providers participating in CHIP and Medicaid programs.
- Hospitals and nursing homes (recipients under Medicare Part A).
- Medical, preventative, and mental health services providers covered under Medicare Part B.
- Medicare Advantage Plans (e.g., HMOs and PPOs) (recipients under Medicare Part C).
- Prescription Drug Plan sponsors and Medicare Advantage Drug Plans (recipients under Medicare Part D).
- Human or social service agencies.
- Insurers who are participating in the Marketplaces and receiving premium tax credits.
Exceptions to the rule
There are five content exceptions to this rule, mostly content that exists prior to the effective date and is no longer current:
- Archived web content (content that is solely for historical purposes and no longer being actively used).
- Preexisting conventional electronic documents (ie: PDFs).
- Content posted by a third party, unless the third party is posting due to contractual, licensing, or other arrangements with the recipient.
- Individualized, password-protected documents or otherwise secured conventional electronic documents.
- Preexisting social media posts.
What to do
You’ll need to be WCAG 2.1 level AA conformant by either 2027 or 2028. To do that, you’ll want to create and follow a plan to get your online presence ready.
In 2026, you want to create new content that meets accessibility guidelines. This will create the right habits, and ensure that your organization has correct processes to produce accessible content reliably. You’ll want to implement a spot check plan to regularly check the content to see if your new plan and procedure for adding content is going well or poorly. You’ll then want to update your procedures and add training for your people as needed.
In 2024 or early 2025, you’ll want to perform a gap assessment. A gap assessment determines the current state of your website and what needs to be done to get your website to WCAG 2.1 level AA. This will allow your organization a structured update process and allow you to allocate money as needed.
In 2025, you’ll want to start implementing the accessibility updates. This is called remediation for the website.
In 2026 and beyond, you’ll want to monitor the accessibility of the website, and you’ll want to remediate it as needed. You will need to have in place a plan to do monitoring of the website and find out if issues are appearing and what the causes of those issues are.
What you’ll want to do is bring in a specialist to assist you with the gap assessment and creating a plan going forward. A specialist can also help you with writing new procedures, specifically tailored to your organization and the type of content that you produce.
If you’re going to be working with a web agency and having them build websites for you or do content updates for you, you’ll want to ask questions about their training and expertise. Ask to speak with the agency’s accessibility specialist. Ask about any certifications that the specialist has and how long they’ve been working in accessibility and how they contribute to the web accessibility community.
You’ll want to have a plan in place to check on work done by any agency on your behalf. A recent lawsuit happened in California. The Parks Department hired an agency to build an accessible website. That was part of the contract. Unfortunately, the Parks Department did not, at any point, actually check the accessibility of the website. They just trusted the agency to deliver. The resulting website was not accessible.
There was a lawsuit for millions of dollars because of that inaccessible website. You want to make sure that you are regularly checking on the agency and not just trusting their word. Of course, if an agency says, “Oh, we’ll just use an overlay,” it’s time to move on to the next agency.