Affordable Care Act Section 1557: What You Need To Know

Section 1557 is the non discrimination provision of the Affordable Care Act (ACA). Section 1557 has been in effect since 2010, and the final rule implementing Section 1557 was implemented earlier this year. It brings together, expands upon and works alongside the following established federal laws regarding civil rights:

  • Title VI of the Civil Rights Act of 1964
  • Title IX of the Education Amendments of 1972
  • Section 504 of the Rehabilitation Act of 1973
  • The Age Discrimination Act of 1975

What does this Section 1557 mean for healthcare providers?

According to the U.S. Department of  Health & Human Services website, Section 1557 prohibits discrimination by any of the following:

  • Any health program or activity receiving federal funding (ex: Medicaid, Children’s Health Insurance Program (CHIP))
  • Any health program or activity that is administrated by a federal agency (ex: Medicare)
  • Any health program or activity that was created under Title I of the ACA  (ex: state partnership or state-based and federally facilitated health insurance marketplaces)

What must be provided?

Providers must provide LEP patients with qualified interpreters at the cost of the provider. They cannot force a patient to provide their own, nor can they discourage a patient from accepting language access services. Providers must also provide written translations. Such translations must be provided by qualified translators for all healthcare translations.

What are qualified interpreters?

Healthcare providers and healthcare facilities must provide qualified interpreters for LEP patients. (See Subpart C to Section 1557 and Subsection 92.201.)

What makes an interpreter qualified?

  • A qualified interpreter follows rules of client or patient confidentiality. (Non disclosure agreements (NDAs) or confidentiality agreements can and should be signed.)
  • Qualified interpreters should be proficient in English and the language that they are interpreting.
  • Interpreters must understand specialized phrases and vocabulary and interpret accurately and impartially.

What makes an interpreter unqualified?

By requiring provision of qualified interpreters, healthcare facilities are eliminating any risk of having untrained people interpreting important medical information.

  • Minors are prohibited from being used as interpreters, unless there is “an emergency involving an imminent threat to the safety or welfare of an individual or the public where no qualified interpreter is immediately available.”
  • Adult family members and friends are prohibited from being used as interpreters. There are two exceptions: the first being the same regarding emergency situation as with minors, and the second is only at the insistence of the LEP patient. The provider is still required to provide a medical interpreter in these cases.
  • Multilingual staff members are prohibited from being used as interpreters unless they are trained as medical interpreters.

What Languages Are Required?

The Office for Civil Rights (OCR) has identified the Top 15 Languages Spoken by Individuals with Limited English Proficiency. Entities must post a notice in these top 15 languages spoken. The notice must say that communication assistance is available. They have translated resources available on their website.

The top 15 languages are:

  1. Spanish (US)
  2. Korean
  3. Arabic
  4. Portuguese (European)
  5. Italian
  6. Chinese (Traditional)
  7. Tagalog
  8. French Creole (Haitian Creole)
  9. Polish
  10. German
  11. Vietnamese
  12. Russian
  13. French
  14. Japanese
  15. Farsi (For Persian)

Note, the site is also very helpful in designating which dialect of certain languages should be chosen. The languages listed in bold have these designations. If you are looking for more help, check out the FAQ for the top 15 languages. Or, you can ask your language service provider for guidance.

The site also lists the top 15 languages other than English spoken by all 50 states, the District of Columbia, and all U.S. territories.

Questions on Section 1557, what it means for you, and how LinguaLinx can help? Do not hesitate to contact us.

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