If you provide health services and receive federal financial assistance for any part of that, you must abide by the Affordable Care Act’s requirements. This includes changes in Section 1557 of the ACA, which affect how you provide medical language services in order to stay compliant. Under this new law, health care providers such as hospitals, physicians, nursing homes, and health insurance companies must provide Limited English Proficiency (LEP) patients with a qualified interpreter.
Breaking down the terms of this legislation
This new law requires that all LEP patients be provided a qualified interpreter via a remote interpreting service or an on-site interpreter, but how is that defined? A Limited English Proficiency (LEP) person is someone with a limited ability to read, write, speak, or understand English and whose primary language for communication is not English. A qualified interpreter under this new law is someone who:
- adheres to generally accepted interpreter ethics principles, including client confidentiality;
- has demonstrated proficiency in speaking and understanding both spoken English and at least one other spoken language; and
- is able to interpret effectively, accurately, and impartially, both receptively and expressly, to and from such language(s) and English, using any necessary specialized vocabulary and phraseology.
What is different under Section 1557?
This regulation has set up stricter guidelines for interpreter training. Before Section 1557, interpreters who identified as “bilingual” were sufficient to be considered qualified. Now, a qualified interpreter must complete advanced training in English and at least one other language, and be educated in HIPAA provisions and confidentiality standards. Section 1557 now requires a qualified interpreter be provided for all on-site and remote appointments.
Is anyone prohibited from interpreting and are there exceptions?
An LEP patient’s child or any accompanying minor or adult family member or friend cannot be relied on as a qualified interpreter. A bilingual employee may be used if and only if he/she is formally trained and interpreting is included in that person’s job description.
There are two exceptions to this rule provided. The first is allowed when a medical emergency poses an imminent threat to the patient or public without an interpreter available. Another exception is allowed if an adult family member or friend is specifically requested to be included by the patient.
What about providing written translations?
Section 1557 now also requires qualified medical translators to translate all written translations that will be provided to patients. Qualified translators complete advanced education, testing, and training programs similar to qualified interpreters.
Whether providing care or other health services, providers are likely to meet patients at some point who do not speak English very well or at all. Hiring a professional language services company for translation and interpretation ensures that medical providers are better able to communicate with LEP patients and stay in compliance with federal law.