Question · HHS §1557
What's the difference between §1557's algorithm provision and its gender-identity provisions?
Section 92.210 bars covered entities from discriminating on the basis of race, color, national origin, sex, age or disability through patient care decision support tools, a term that covers any automated or manual tool supporting clinical decisions, including AI.
01 / The answer
The short answer
They are separate parts of the 2024 rule with different legal status. §92.210 bars discrimination on race, color, national origin, sex, age or disability through patient care decision support tools, including AI, and remains in force. The provisions that extended sex discrimination to gender identity, such as §92.101(a)(2)(iv) and §92.206(b), were vacated by a federal court on October 22, 2025, and HHS says it will not enforce them. §92.210 still lists sex, but the regulatory text that defined sex discrimination to include gender identity is void.
02 / The rule
What HHS §1557 requires
Section 92.210 bars covered entities from discriminating on the basis of race, color, national origin, sex, age or disability through patient care decision support tools, a term that covers any automated or manual tool supporting clinical decisions, including AI. Since May 1, 2025, covered entities must make reasonable efforts to find tools that use those characteristics as inputs and to reduce the discrimination risk.
- 01Do not discriminate on race, color, national origin, sex, age or disability through patient care decision support tools.
- 02Make ongoing reasonable efforts to identify tools whose input variables measure race, color, national origin, sex, age or disability.
- 03For each identified tool, make reasonable efforts to mitigate the risk of discrimination from its use.
- 04Cover tools used in clinical decision-making, whether automated (including AI) or non-automated.
03 / Records
Records to keep
- 01Inventory of clinical decision support tools and their input variables
- 02Bias risk assessment for tools using protected characteristics
- 03Mitigation decisions and actions, with dates and owners
- 04Section 1557 policies, procedures and staff training records
Optional evidence · where Planisphere fits
Keep a record anyone can check
When your team meets a duty, Planisphere can seal the event it reports as a receipt.
A disclosure shown, a review signed, a model change approved: the event your system reports.
The event becomes a sealed receipt, dated and attributed to whoever is signed in.
Paste the receipt into Verify. No account or key.
A record supports your compliance evidence process. It is not a legal finding or a certification. Systems that call Planisphere's gate API can also hold or refuse an action before it runs.
SOURCES
Go back to the source
Federal Register (HHS)
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Related: HHS §1557: the full guide · Is the HHS §1557 patient-care-decision-support-tools rule still in effect in 2026? · How do I audit a clinical algorithm for §1557 nondiscrimination?