New Disability Rules for Medical Equipment Take Effect This Summer

By July 8, 2026, nearly all healthcare facilities across the country will have to demonstrate that they have the proper amount of accessible medical diagnostic equipment (such as mammography equipment and X-ray machines) to ensure individuals with disabilities are not discriminated against. Two overlapping regulations, one from the Department of Health and Human Services (HHS) and another from the Department of Justice (DOJ), require healthcare providers to ensure that at least 10% — or more in certain cases — of their medical diagnostic equipment (MDE) meet certain accessibility standards.  

Importantly, the rules do not require all existing equipment to be upgraded, nor do they require that all newly purchased equipment meets the additional accessibility standards. Instead, the rules require that facilities satisfy so-called “scoping requirements,” which would ensure that individuals who have disabilities do not face delays or discrimination accessing care.  

Key Definition

Medical diagnostic equipment (MDE) means equipment used in, or in conjunction with, medical settings by healthcare providers for diagnostic purposes. MDE includes, for example, examination tables, examination chairs (including chairs used for eye examinations or procedures and dental examinations or procedures), weight scales, mammography equipment, X-ray machines, and other radiological equipment commonly used for diagnostic purposes by health professionals.

Timeline

On July 8, 2024, HHS finalized a rule titled “Nondiscrimination on the Basis of Disability in Programs or Activities Receiving Federal Financial Assistance.” Large providers (15 or more employees) were given two years to comply with the rule, while small providers (14 or less employees) were given three years to comply.

Another very similar rule, finalized on August 8, 2024, by the DOJ, requires publicly owned healthcare facilities to comply with the scoping requirements within two years. However, because almost all publicly owned healthcare facilities provide care to Medicare and Medicaid patients, they will need to comply with the HHS rule by July 8, 2026.

Applicability

Any provider who sees Medicare and/or Medicaid patients must comply with the HHS rule, while publicly owned healthcare facilities must comply with both. The two rules were written in parallel and impose virtually the same accessibility requirements on healthcare facilities.

Rationale

HHS explains in its rule that:

The Department is aware of many instances where people with disabilities were denied access to needed care, subjected to demeaning situations, or received substandard care because recipients did not utilize accessible exam tables, weight scales, radiological, or other diagnostic equipment. The Office of Civil Rights has taken action to enforce section 504 as it applies to medical care. However, the lack of standards for accessible MDE before the Access Board completed its standards in early 2017, the lack of scoping and rulemaking to make these standards enforceable for recipients, and modest voluntary adoption of accessible MDE by healthcare providers mean that these circumstances remain all too prevalent. This rulemaking and its effective date will be turning points in ensuring improved access to diagnostic services for people with disabilities.

Key Requirements

At least one unit of each type of MDE that a facility uses must meet the U.S. Access Board’s accessibility requirements. Additionally, 10% of a facility’s MDE must also meet the accessibility requirements. This increases to 20% if the facility specializes in treating conditions that affect mobility. Large facilities with multiple departments must disperse the accessible MDE proportionately across all specialties that use that MDE.

To meet these accessibility requirements, X-ray and mammography machines need to be able to accommodate patients in wheelchairs, have support features such as grab bars or support straps, and be adjustable enough for use by patients in standing or seating positions.

The rules specifically require facilities to have at least one adjustable height exam table with a 17-inch low transfer height and a 25-inch transfer height. Facilities will also need at least one accessible weight scale that accommodates wheelchairs and meets the MDE standards.

Exceptions: Fundamental Alterations and Undue Burdens

Facilities that can demonstrate that these requirements would result in “fundamental alteration in the nature of a program or activity, or in undue financial and administrative burdens” would be granted an exception to the rules.

If a facility can prove that compliance with these rules would prevent the intended diagnostic use of the equipment, then the facility would also be granted an exception.

Other Aspects of the Disability Rules

The rules also require facilities to comply with the “Web Content Accessibility Guidelines” (WCAG 2.1) for its web content and mobile apps. Check-in kiosks must be made accessible to individuals with disabilities if possible. Facilities must ensure that people who cannot use kiosks have the same access, convenience, and confidentiality that a kiosk system provides. Separately, the rules require that healthcare facilities make reasonable modifications to permit the use of a service animal (including a miniature horse) by individuals with disabilities.

Gray Areas

While mammography equipment and X-ray machines are explicitly called out in the definition of MDE, how far the term “other radiological equipment commonly used for diagnostic purposes” extends is unclear to me. For example, does the definition of MDE include ultrasound, MRI, or CT equipment?

What constitutes an “undue financial and administrative burden” and the criteria for providers to meet the key exception is also unclear. However, the rule does explicitly state that the burden of proof lies with the healthcare providers. In most cases, HHS views that compliance would not result in undue financial or administrative burdens for providers.

Enforcement

Enforcement is handled by HHS Office of Civil Rights (OCR). The OCR investigates all complaints from the public within 180 days of the alleged discrimination unless time is extended by HHS. In comments on the proposed rule, many disability rights groups asked HHS to hire more investigators noting that without “teeth” the regulation is not useful. In response to this critique, HHS noted that they “will continue to efficiently address complaints and conduct compliance reviews consistent with the finite resources that [they] have available.”

Ultimately, if facilities are found to be out of compliance with the rule, the OCR and HHS will work with the facility to bring them into compliance. If compliance cannot be achieved through voluntary means, the OCR can escalate the matter to the DOJ or terminate the provider’s ability to receive Medicare/Medicaid reimbursement.

Bottom Line

Unless your imaging centers or radiology departments do not serve Medicare/Medicaid patients, AHRA members should ensure that their facilities have a sufficient amount of equipment that meets the U.S. Access Board’s accessibility standard to service individuals with disabilities. This is a new and key rule implementing the broader principle that all healthcare providers must not discriminate against individuals with disabilities.

Imaging leaders need to make sure that their facilities are in compliance with these new rules by July 8. While you won’t be closed down on July 9 if you don’t have everything in place, you will open yourself up to a potential OCR investigation if you are not prepared. Whether your system has compliance staff, or whether you will have to make these changes on your own, make sure that someone in your facility is responsible to implement these new standards.