Effective May 11, many physicians are required to make their practice’s patient-facing technology – including websites, mobile apps, and kiosks – compliant with technology accessibility standards added to regulations implementing decades-old federal disability laws.
The U.S. Department of Health and Human Services (HHS), through its Office for Civil Rights (OCR), updated its regulations implementing the Americans with Disabilities Act (ADA) and the Rehabilitation Act of 1973 after finding many of them didn’t clearly apply to health care-related information, access, and services provided through websites, mobile apps, kiosks, and more.
Now, for the first-time, health care professionals or organizations that receive federal financial assistance must make sure their patient-facing technology is ADA-compliant, such as by providing alt text or descriptions for images, graphics, and maps for blind patients using screen readers, or adding captions to videos for individuals who are deaf or hard of hearing.
Federal financial assistance from HHS includes credits, subsidies, and insurance contracts, such as Medicare parts A, B, C, and D; Medicaid funding; funding for the Children’s Health Insurance Program, Temporary Assistance for Needy Families, HeadStart, and the Supplemental Nutrition Assistance Program; financial aid for child welfare programs; and funding to support clinical research.
Health care organizations with 15 or more employees must comply by May 11, 2026, while those with fewer than 15 employees must do so by May 10, 2027. According to HHS, 100% of hospitals and 92% of office-based physicians nationwide are subject to the new rules.
The agency acknowledges complying may cause undue burden on practices, especially those with less resources to provide care to disabled patients, saying this is why it will allow small practices more time to update their accessibility practices.
The regulation has some exceptions, in addition to other flexibilities. The requirements do not apply to:
- Preexisting conventional electronic documents;
- Web content posted by a third party, unless posted on behalf of the physician/health care entity due to contractual, licensing, or other arrangements;
- Linked third-party web content;
- Password-protected course content for elementary, secondary, and postsecondary institutions; and
- Individualized password-protected documents.
Further, physicians and health care entities are not required to take action that would constitute “a fundamental alteration in the nature of a program or activity or an undue financial or administrative burden.” The department notes that whether the undue burdens limitation applies is fact-specific and “would depend, among other things, on how large the recipient's operating budget is and how much it would cost to make the materials in question accessible.”
Another flexibility in the rule allows, under certain circumstances, the use of alternative versions of web content and mobile apps, so long as the alternate versions are accessible, up to date, contain the same information and functionality as the inaccessible version, and can be reached in particular ways.
In the context of kiosks that do not rely on web content, physicians and health care entities are allowed to implement procedures that allow people with disabilities to access programs without using a kiosk. For instance, a practice with an inaccessible kiosk can offer registration at the front desk.
HHS said in its rule that alternative procedures help to avoid instances where complying with the rule would be burdensome.
“The Department believes that the final rule strikes the appropriate balance by requiring small [practices] to comply with the same technical standard as larger recipients while giving small recipients additional time to do so,” HHS said in the rule.
If physicians fail to comply, they may face risk of investigation by OCR, HHS says in its fact sheet.
Physicians should ask their website provider about ADA compliance, says Shannon Vogel, the Texas Medical Association’s associate vice president for health information technology. If a physician is employed, she recommends they confirm compliance with their organization’s chief technical officer or information technology department.
The rule specifically requires standards under Web Content Accessibility Guidelines. The guidelines require digital information to be:
- Presented to patients, in ways they can perceive;
- Operable with various input devices, such as a mouse or a keyboard;
- Understandable to all people regardless of ability; and
- Robust enough to be interpreted reliably by a wide variety of accessibility aids.
HHS’ rules also apply to mobile applications operated by third parties on a practice’s behalf, such as appointment schedulers, patient registration platforms, bill pay portals, and telehealth platforms. Ms. Vogel recommends physicians confirm third-party vendors under contract to provide digital services are aware of and adhering to accessibility standards. For more information about health information technology, see TMA’s Health Information Technology webpage.
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