Section 1557: Is your medical practice meeting compliance for patients with Limited English Proficiency (LEP)?
Across the country, physician practices are required under federal and state laws to provide interpreters for patients with limited English proficiency and for those who are deaf or hard of hearing. There are very limited exceptions, which we discuss below. Use of interpreters or translation services may be necessary to ensure that patients can give informed consent. There are several sources for interpreters that physicians can use, including phone-based interpreters, in-person interpreters and online translation services.
In May 2016, the US Department of Health and Human Services (HHS) issued a Final Rule implementing a prohibition on discrimination by healthcare services found in Section 1557 of the Affordable Care Act (ACA). Section 1557 builds on long-standing federal civil rights laws that have already applied to most healthcare practices, such as Title VI of the Civil Rights Act. The requirements of the Section 1557 Final Rule and Title VI are consistent and should generally be reviewed together – though Section 1557 provides further detail in several areas.
The Section 1557 Final Rule applies to “every health program or activity, any part of which receives federal financial assistance.” HHS expects that this applies to almost all physician practices in the nation as federal financial assistance includes, but is not limited to: state Medicaid payments, “Meaningful Use” payments, National Health Service Corp funding, NIH research funding and CMS gain-sharing payments. Physician practices that exclusively receive Medicare Part B payments are not included, but practices should conduct a thorough review of their funding sources and consult an attorney before deciding they are exempt.
The most immediate requirement took effect on Oct. 17. On this date practices receiving federal funds from HHS must begin to “conspicuously” publicize the notice of nondiscrimination, which describes the practices’ obligations under the rule and a patients’ rights in English as well as the top 15 languages spoken in the state. Here is an explanation of what is required along with copies of the notice in the various languages. More information as well as answers to frequently asked questions is available on the Office of Civil Rights website.
The North Carolina Medical Society (NCMS) Solution Center has been fielding inquiries on this rule and collecting useful links on the OCR site to help answer your questions.