An upcoming federal rule will strengthen the anti-discrimination requirements for CAHs participating in Medicare. Because discrimination leads to a denial of services or inequity in the care received, the rule inserts explicit anti-discrimination provisions into CAH Conditions of Participation (CoPs). The CoPs will require written policies prohibiting specific types of discrimination. CAHs will also be required to inform each patient of the right to be free from discrimination and the availability of assistance should they encounter discrimination. CAHs will need to update or implement new policies prohibiting discrimination, a substantial undertaking for many small facilities. This presentation will discuss (a) the impact of these changes on CAHs, (b) how they will affect provider-patient dynamics, (c) information about the penalties for violations, and (d) the interplay of discrimination allegations with Medicare reimbursement.