The HHS Section 504 rule: deadlines for health and human services
In May 2024 the US Department of Health and Human Services finalized a Section 504 rule for organizations that receive HHS funding. It requires their web content, mobile apps and electronic documents to conform to WCAG 2.1 Level AA — by May 11, 2027 for recipients with 15 or more employees and by May 10, 2028 for smaller recipients, after HHS extended both dates by one year on May 11, 2026.
The rule
What is the HHS Section 504 final rule?
It is a Department of Health and Human Services regulation, published in the Federal Register on May 9, 2024, that updates Section 504 of the Rehabilitation Act for recipients of HHS federal financial assistance. Among its provisions, it makes WCAG 2.1 Level AA the enforceable standard for recipients' websites, mobile apps and posted documents.
It is the first comprehensive update to HHS's Section 504 regulation in roughly fifty years, and its web and mobile provisions deliberately mirror the Department of Justice's ADA Title II rule — same technical standard, closely aligned definitions and exceptions — so health organizations face one consistent bar.
Who is covered
Who must comply with the HHS Section 504 rule?
Any organization receiving federal financial assistance from HHS, public or private. One stream of HHS funding brings a recipient's programs under the rule.
| Recipient | Covered | Common funding route |
|---|---|---|
| Hospitals, health systems, clinics and community health centers | Yes | HHS grants and Medicaid participation |
| Physician, therapy and behavioral health practices | Yes | Medicaid participation — the most common route |
| State and local health and human services agencies | Yes | HHS-funded programs — also covered by ADA Title II |
| Child welfare, foster care, aging, disability and early childhood programs | Yes | HHS grants |
| Research institutions, nonprofits and community organizations | Yes | HHS grants |
| A provider taking no federal funds | No | Other law may apply — ADA Title III, state law |
Employee count does not decide whether the rule applies — only which compliance date governs. A three-person clinic receiving HHS funds is covered; it simply gets the later date.
The dates
When are the HHS Section 504 compliance dates?
Recipients with 15 or more employees must comply with the web, mobile and document requirements by May 11, 2027; recipients with fewer than 15 have until May 10, 2028. These are the extended dates — an HHS interim final rule of May 11, 2026(opens in new tab) moved each of the 2024 rule's dates back by one year. The extension does not pause the underlying Section 504 duty, which continues throughout, and HHS has said it may propose further changes.
| Recipient | Compliance date | Status |
|---|---|---|
| Recipients with 15 or more employees | 7 months away | |
| Recipients with fewer than 15 employees | 19 months away |
Documents
Does the HHS rule cover PDFs and patient documents?
Yes. The rule's web accessibility requirements reach conventional electronic documents — PDFs, word processor files, presentations and spreadsheets — that a recipient makes available through its website or mobile app. Patient intake and consent forms, benefit notices, discharge instructions and plan documents must conform to WCAG 2.1 Level AA unless a narrow exception applies.
The exceptions(opens in new tab) mirror the ADA Title II rule: archived web content and preexisting conventional electronic documents are excepted, but the exception ends the moment a document is currently used to apply for, access or participate in the recipient's programs. An intake form or benefits application can never rely on it, whatever its posting date.
Side by side
How does the HHS rule relate to ADA Title II?
Same technical standard — WCAG 2.1 Level AA — and closely aligned exceptions; different organizations, different dates.
| Comparison | HHS Section 504 | ADA Title II |
|---|---|---|
| Covers | HHS funding recipients — public or private | State and local governments |
| Standard | WCAG 2.1 Level AA | WCAG 2.1 Level AA — the same |
| Dates | May 11, 2027 · May 10, 2028 | April 26, 2027 · April 26, 2028 |
| Threshold | Employee count — 15 | Population served — 50,000 |
| Enforced by | HHS Office for Civil Rights; private lawsuits | Department of Justice; private lawsuits |
| Exceptions | Five, including archived content and preexisting documents (45 CFR 84.85) | Closely aligned (28 CFR 35.201) |
Many public entities sit under both: a county health department is a Title II entity and, if it takes HHS funding, a Section 504 recipient. Same standard, same exceptions — one remediation pass serves both, and the earlier applicable date governs planning: each HHS date falls about two weeks after the matching Title II date.
The work
What should a covered organization do now?
The order is the same whether your date is months away or further — and it gives a compliance office something to show.
The extension moved the date, not the duty: the Department wrote that recipients have an ongoing obligation to ensure that their programs and activities offered using web content and mobile apps are accessible to individuals with disabilities
(91 FR 25496)(opens in new tab). Enforcement runs through HHS Office for Civil Rights complaints and investigations; what matters when one arrives is what you can show.
Inventory: enumerate every PDF and Office document on your public domains. Content behind a patient-portal login is not crawled — those files reach us through a connection.
Prioritize: forms and notices patients and beneficiaries currently use come first — they have no exemption.
Remediate and verify: bring files to WCAG 2.1 AA and PDF/UA, keeping a verification report for each one.
Fix the pipeline: new patient-facing documents should go out accessible from day one.
This is not legal advice and it is not a defence. It is the order the work goes in.
FAQ
HHS Section 504 document questions, answered
General information, not legal advice: which rule applies to you, and when, is a question for your counsel.
Does the HHS Section 504 rule apply to private medical practices?
Yes, if the practice receives federal financial assistance from HHS — participating in Medicaid is the most common route. Private status does not matter under Section 504; what matters is the funding relationship. A covered private practice follows the same WCAG 2.1 AA requirements and the same May 11, 2027 or May 10, 2028 date as any other recipient.
Which date applies if my organization has exactly 15 employees?
The earlier one: the rule draws the line at fewer than 15 employees. An organization with 15 or more employees must comply by May 11, 2027; only recipients with 14 or fewer have until May 10, 2028. Count employees the way the rule and your counsel direct, and document the basis for the count you use.
Do paper forms have to meet WCAG under this rule?
The WCAG 2.1 AA requirement targets web content, mobile apps and the electronic documents they deliver. Paper handed over a counter is governed by the rule's broader effective-communication obligations instead. But the moment a form is scanned and posted to your website or portal, it is web content and must conform.
We are a county health agency — does Title II or the HHS rule apply to us?
Likely both. As a local government entity you are covered by ADA Title II, and as a recipient of HHS funding you are covered by the Section 504 rule. The standards are the same WCAG 2.1 Level AA; the practical consequence is timing — each HHS date falls about two weeks after the matching Title II date, so the Title II date is the one to plan around.
Are old documents on our site exempt?
Only within the narrow archived-content and preexisting-document exceptions, which mirror ADA Title II. Both end when a document is currently used to apply for, access or participate in your programs — so live intake forms, consent packets and benefits applications must conform regardless of when they were posted.
HHS extended the dates. Should we wait?
No. The extension moved the dates by one year; it did not pause the Section 504 obligation, which HHS says continues throughout, and HHS may propose further changes. The forms patients currently use have no exception at any date, so the order of work is unchanged: count what you publish, fix the documents people must act on, keep a dated verification record.
Sources
Every regulatory claim on this page is cited to one of these primary sources.
- US Department of Health and Human Services — Section 504 Final Rule (HHS.gov)
- Federal Register, May 9, 2024 — Final rule: Nondiscrimination on the Basis of Disability in Programs or Activities Receiving Federal Financial Assistance
- Federal Register, May 11, 2026 — Interim final rule: Extension of Compliance Dates (91 FR 25496), amending 45 CFR 84.84(b)
- eCFR — 45 CFR 84.84, requirements and compliance dates (current text)
- eCFR — 45 CFR 84.85, exceptions
- W3C — Web Content Accessibility Guidelines (WCAG) 2.1
- eCFR — 28 CFR 35.200, the web and mobile accessibility requirements as currently in force
Changelog
- Dates confirmed against 45 CFR 84.84(b) as amended by the interim final rule of May 11, 2026 (91 FR 25496): both extended by one year; status now computed from the deadline catalog. Notice re-pointed to HHS OCR; coverage and Title II tables; hub, product and scan links.
- Initial publication.
Reviewed quarterly, and whenever a cited source changes; every published date is checked against the catalog at each review. Next review: December 18, 2026.