New Rules on Medical Diagnostic Equipment improve healthcare access

Equal Health Access, Newsletters

“Do you know how much you weigh?” This is a rude question in most circumstances, but when you seek medical care, it can be dangerous. I have been asked this question countless times by healthcare providers, including twice in the past month because I use a wheelchair and they don’t have a wheelchair-accessible scale. Without an accessible scale, healthcare providers cannot determine my current weight. Accurate weight is vital for identifying disease onset (e.g., cancer), medication side effects, and anesthesia and medication dosing for surgical procedures.

Two studies, one on health clinics and one on wheelchair-users in the Louisville area, corroborated my experience. A majority of clinic managers (70%) reported not having a height-adjustable exam table or access to a wheelchair-accessible scale. Most wheelchair users experienced physical barriers in doctors’ offices (73.8% primary care; 68.5% specialty), and more than half felt they received incomplete care (54.1%).

Typically, medical exam tables, mammography machines, and other diagnostic equipment don’t adjust low enough, making it difficult or impossible for people with disabilities to use them. This means:

People in wheelchairs can’t transfer to exam, CT, MRI, and other tables
Some people can’t get important health screenings
Doctors struggle to provide full medical care

New Rules. Better Care.

The U.S. Access Board is a federal agency empowered by Congress to develop minimum accessibility guidelines and standards for the built environment, transit vehicles, communication technology, etc. Other U.S. agencies can create regulations that adopt these guidelines. A Final Rule has the force of law. It is the culmination of the federal agency rulemaking process that establishes regulations.

In 2010, the Access Board was mandated by the Affordable Care Act to develop accessibility guidelines for accessible medical diagnostic equipment. It was not until 2024 that the U.S. Department of Health and Human Services (HHS) and the Department of Justice (DOJ) each issued a Final Rule to set specific requirements for medical diagnostic equipment in their respective purviews.

What is Medical Diagnostic Equipment (MDE)?

Examination tables
Examination Chairs (including those used for dental or optical exams)
Weight Scales
Radiological Equipment, including X-ray, MRI, CT, and mammography equipment
Other equipment used for medically diagnostic purposes

The Access Board’s Key Requirements for MDE

Examination tables
Examination Chairs (including those used for dental or optical exams)
Weight Scales
Radiological Equipment, including X-ray, MRI, CT, and mammography equipment
Other equipment used for medically diagnostic purposes

See all of the requirements at the Access Board’s website.

What the HHS and DOJ Final Rules Require.

The Americans with Disabilities Act (ADA) empowers the U.S. Department of Justice (DOJ) to create regulations that establish how the ADA is enforced. On August 9, 2024, the DOJ promulgated an MDE final rule under Title II of the ADA. Title II applies to all state and local governments which means the final rule must be followed by public hospitals, public healthcare clinics, and public universities’ healthcare systems. The ADA empowers individuals to file complaints to enforce the rules.

The Rehabilitation Act of 1973 empowers the U.S. Department of Health and Human Services (HHS) to create regulations. Section 504 of the statute prohibits discrimination based on disability by any entity that receives funds from the federal government. Federal funds include Medicaid and Medicare payments, which all hospitals and most healthcare providers receive as insurance payments for treating patients. So, the DOJ’s final rule must be followed by these providers. As with the ADA, individuals have a private right of action to enforce the regulations for section 504 of the Rehabilitation Act.

Key Requirements of the HHS Rule*:

Starting July 8, 2024, for entities that use MDE, all newly purchased MDE must comply with the rule until:
- 10% of the total number of MDE units, but no fewer than one of each type of equipment in use, is acquired.
- 20% for rehabilitation facilities that treat mobility conditions.
Alternatives are allowed (e.g., lifts) if they provide equivalent or better accessibility.
By July 8, 2026, for entities that use weight scales and exam tables, at least one of each piece of equipment must be acquired in the locations where they are used.

Key Requirements of the DOJ Rule*:

Starting October 8, 2024, for entities that use MDE, all new MDE must comply with the rule until:
- 10% of the total number of MDE units, but no fewer than one of each type of equipment in use, is acquired.
- 20% for rehabilitation facilities that treat mobility conditions.
Alternatives are allowed (e.g., lifts) if they provide equivalent or better accessibility.
By August 9, 2026, for entities that use weight scales and exam tables, at least one of each piece of equipment must be acquired in the locations where they are used.

*Disclaimer: Consult official HHS and DOJ guidelines for complete details.

How you can help:

Learn More: Visit the Access Board website or ADA.gov to read about the new rules. See the full text of the HHS rule and the full text of the DOJ rule.
Speak Up: If you or someone you know faces barriers to accessible medical equipment check out Gathering Strength’s blog post on equal healthcare services. The post includes information on how to complain by reporting the issue (in writing) to the facility, contacting the ADA Technical Assistance Program, filing a complaint with the DOJ’s Civil Rights Division and the Office of Civil Rights at Health & Human Services.
Advocate for Awareness: Share information about the rules with your community and your healthcare providers to help educate others about their importance.

Another informative resource is a video on the final rules done by the Great Lakes ADA Center and Access Board staff.

Elizabeth Fust, Founder & Executive Director