HHS Website Accessibility Requirements: What Healthcare Practices Need to Know About WCAG Compliance

In 2024, the U.S. Department of Health and Human Services (HHS) finalized updates to its Section 504 nondiscrimination regulations, creating clear and enforceable requirements for digital accessibility across healthcare websites and digital tools.

For many healthcare organizations, this represents the first time website accessibility has been explicitly tied to federal healthcare compliance — and it has understandably raised questions about what’s required, when it applies, and how to comply without unnecessary risk or cost.

This article explains what the new HHS accessibility rule means, how it relates to WCAG 2.1 Level AA, and how healthcare practices should evaluate accessibility solutions realistically and responsibly.

What Is the New HHS Accessibility Requirement?

HHS updated Section 504 of the Rehabilitation Act to clarify that healthcare organizations receiving federal financial assistance must ensure that their websites, web content, and often mobile applications are accessible to individuals with disabilities.

Under the rule, covered entities must conform to:

WCAG 2.1 Level AA (Web Content Accessibility Guidelines)

This standard applies to:

• public-facing healthcare websites
• online forms and patient education content
• PDFs and downloadable resources
• patient-facing workflows such as appointment requests and bill pay
• mobile apps (where applicable)

When Does This Take Effect?

Compliance deadlines are phased:

• Organizations with 15 or more employees: May 11, 2026
• Organizations with fewer than 15 employees: May 10, 2027

While those dates may seem distant, remediation and governance often take months, not weeks — especially for organizations with large or frequently updated websites.

Who Should Pay Attention to This?

If your organization:

• accepts Medicare, Medicaid, or other federal funding
• is part of a hospital system, specialty group, or multi-location practice
• publishes patient-facing content online
• uses third-party digital tools embedded into your website

…this rule likely applies to you.

Even organizations not strictly covered under Section 504 should pay attention. Website accessibility lawsuits continue to rise, and healthcare organizations are frequent targets due to the essential nature of their services.

What WCAG 2.1 AA Actually Requires (in Plain Language)

WCAG is not a single feature or plugin — it’s a set of technical and content standards designed to ensure websites can be used by people who rely on assistive technologies.

At a high level, WCAG requires that websites be:

1. Perceivable

Users must be able to perceive content, even if they can’t see or hear it.

• meaningful alternative text for images
• captions or transcripts for relevant media
• sufficient color contrast

2. Operable

Users must be able to navigate and interact with the site.

• full keyboard navigation
• visible focus states
• no interaction traps that require a mouse

3. Understandable

Content must be clear and predictable.

• properly structured headings (H1 → H2 → H3)
• descriptive link text (not “click here”)
• accessible form labels and error messaging

4. Robust

Content must work with assistive technologies.

• clean, semantic HTML
• accessible ARIA usage
• compatibility with screen readers and browsers

The Reality of Accessibility Overlays (accessiBe, UserWay, etc.)

Many healthcare organizations use accessibility overlays because they are:

• fast to deploy
• inexpensive upfront
• marketed as “WCAG compliant” solutions

However, it’s important to understand their limitations.

Why Overlays Alone Are Not Enough

Accessibility overlays do not fix the underlying code or content of a website. They attempt to modify behavior at runtime, which means they cannot reliably resolve issues such as:

• improper heading structure
• inaccessible forms and validation errors
• poorly structured navigation
• inaccessible PDFs
• third-party embeds and widgets

This has led to increased legal scrutiny. In recent years, lawsuits have specifically targeted sites relying on overlays, arguing that the sites remain inaccessible despite the presence of an overlay.

Notably, the FTC took action against accessiBe related to claims that its product could make websites WCAG compliant, reinforcing that no overlay can guarantee compliance on its own.

What Overlays Can Do

Overlays may still have limited value:

• providing user-adjustable UI controls
• offering quick interim improvements
• supporting—but not replacing—structural remediation

They should be viewed as supplemental tools, not compliance strategies.

A Practical, Defensible Path to WCAG Compliance

Healthcare organizations that are approaching this responsibly tend to follow the same core framework:

Step 1: Define Scope

Inventory all patient-facing digital content:

• core website pages
• provider profiles and PDFs
• forms and embedded tools
• third-party platforms surfaced through the website

Step 2: Establish a Baseline (Audit)

Use a combination of:

• automated scanning
• manual keyboard and screen reader testing
• template-level review

This produces a prioritized remediation plan rather than a vague “score.”

Step 3: Remediate at the Template and Code Level

Address issues in:

• site templates
• navigation structures
• form components
• document workflows

This is where most meaningful accessibility improvements happen.

Step 4: Implement Content Governance

Accessibility failures often reappear through new content. Governance should include:

• alt text standards and training
• heading and layout rules
• link text guidelines
• PDF and document policies
• a checklist for new or updated pages

Step 5: Monitor and Document

Ongoing monitoring and documentation helps:

• catch regressions early
• demonstrate good-faith compliance
• support internal and legal accountability

Why Accessibility Is Not a “One-Time Fix”

WCAG compliance is not like installing SSL or updating privacy policies. Websites evolve constantly — especially healthcare sites that add providers, services, blogs, and patient education materials.

Without governance and monitoring:

• new pages introduce violations
• PDFs become liabilities
• third-party updates break accessibility

Sustainable compliance requires process, not just technology.

How Healthcare Practices Should Choose an Accessibility Partner

When evaluating vendors or agencies, ask:

• Do they remediate source code or just add overlays?
• Do they address PDFs and third-party content?
• Do they provide governance guidance?
• Do they document changes and testing?
• Do they avoid making “guaranteed compliance” claims?

Any vendor promising instant or guaranteed WCAG compliance should be viewed cautiously.

Final Thoughts

The HHS accessibility requirement is not about checking a box — it’s about ensuring patients can actually access healthcare information and services online.

Healthcare organizations that take a thoughtful, structured approach now will be better positioned to:

• reduce legal risk
• meet federal expectations
• improve patient experience
• avoid costly rework later

If your organization is beginning to evaluate accessibility solutions, the most important first step is understanding what WCAG compliance really involves — and what it doesn’t.

Download Our Healthcare Website Accessibility Checklist