The enhancement of language assistance services for individuals classified as Limited English Proficient (those whose primary language is not English or speak English less than "very well”) is just one piece of the puzzle in the law's efforts to reduce disparities in healthcare. Since the final rule was implemented, language assistance services have been a hot topic for many health insurers and providers. However, the rule isn’t entirely easy to digest.
Questions such as, ‘Does the Section 1557 regulation affect me?’ ‘What steps are needed when implementing section 1557 of the Affordable Care Act’, and ‘How do I comply with the language access requirements?’ often arise. Additionally, employers may need to know the top 15 languages spoken in their state, and may need to familiarize themselves with non-English languages. To help make sense of the law (and answer these questions), we’re breaking down exactly who the law affects, who is subject to section 1557, and how those affected can get into compliance with section 1557 the language access requirements, with two simple flowcharts:
Are you a health program or activity that:
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Receives Federal financial assistance from the Department of Health and Human Services (HHS)? Health programs and activities include health care providers (such as hospitals, health clinics, physicians’ practices, community health centers, nursing homes, rehabilitation facilities), health plans and health insurers. Examples of Federal financial assistance include grants, tax credits, property, Medicaid and Medicare Part A, C and D payments (Medicare Part B is excluded). |
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Is administered by entities created under Title I of the ACA? Examples of entities created under Title I of the ACA include the State-based and Federally-facilitated health insurance marketplaces. |
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Is administered by HHS? Health programs and activities administered by HHS include Medicare and the Federally-facilitated health insurance marketplaces. |
Do you currently offer:
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Oral interpretation and written translation services? To ensure limited-English speakers have "meaningful access" to care and coverage, entities covered by section 1557 must offer language assistance, such as interpreting and translation services, at no cost to the individual and in a timely manner. |
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Translated nondiscrimination notices? Covered entities must post a nondiscrimination notice in at least English, but are encouraged to post the full 15 nondiscrimination notices translated into the top 15 non-English languages spoken in the State in which the entity is located or does business. Nondiscrimination notices advise individuals with limited English proficiency of their civil rights, while also providing information about language assistance available to them. |
Here’s what you need in order to fully comply with the language access requirements of Section 1557 and better support your Limited English Proficient population:
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When using video remote interpreting services to communicate with a limited-English speaker, you must provide high-quality video technology. |
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For a complete review and explanation of Section 1557, as well as a link to the HHS FAQ page, please see the HHS.gov/civil rights webpage.
The information in this webpage is for informational purposes only, and is not legal advice, regulatory advice, and/or a substitute for legal and/or other expert counsel. The information on this page is not guaranteed to be correct, complete or most current, and should not be relied upon as such. Nothing on this page should be used as a substitute for the advice of competent legal counsel.
Download the step-by-step guide to designing your ideal language access plan.
Learn which questions to ask when evaluating a potential language support provider.
Team up with a language services company who can provide you with oral interpretation and written translation services to support your limited-English speakers.
Use interpreters and translators that are able to interpret/translate effectively, accurately, and impartially (both receptively and expressly) to and from such language(s) and English.
You may not require a limited-English speaker to provide his or her own interpreter or rely on a limited-English-speaking individual's family member, minor child or friend to act as an interpreter. The use of unqualified bilingual staff members is strictly prohibited.
Reasonable steps may include the provision of language assistance services, such as oral language assistance or written translation.