Section 1557- FAQ for Medical Language Services

Everything you need to know about Section 1557 – FAQ Below

Section 1557 of the Affordable Care Act (ACA) went into effect July 18, 2016 and has a direct impact on the laws surrounding medical language services. Under the new law, any healthcare provider or health insurance company receiving federal assistance must provide limited English proficiency (LEP) patients with a qualified interpreter. In the past, interpreters who identified themselves as “bilingual” were deemed competent by the Department of Health and Human Services (DHHS). Section 1557 is the first change to language services since the DHHS regulations of 2003, and enacts stricter guidelines for interpreter training.

To become a qualified interpreter, an individual must complete a rigorous education and advanced training program to obtain advanced knowledge and fluency in English and at least one other language. Qualified interpreters adhere to the code of ethics, principles and confidentiality as practiced in the language services industry. Section 1557 now requires qualified interpreters for on-site and video remote interpretation appointments.

What’s Different Under Section 1557?

Bilingual minors, adult family members, friends and staff prohibited from interpreting

An LEP patient’s child or any accompanying minor or adult cannot be relied on as a medical interpreter. The exception to the rule is when a medical emergency poses imminent threat to the patient or public and an interpreter is not readily available. The second exception is if the patient specifically requests the adult family or friend to be present. In this circumstance, the health care provider is not off the hook legally. An interpreter still needs to be provided.

A bilingual staff member may be used if and only if he/she is formally trained. Oral interpretation must be included in such person’s job description and duties.

Commonly Asked Questions

What’s the difference between a qualified interpreter and a certified medical interpreter?

The new law does not require healthcare entities to provide certified medical interpreters, although it’s implied. The difference between qualified and certified is the type of credential the interpreter possesses. Certified interpreters went one step further to obtain specialization in medical terminology.

Think of this analogy,  a Bachelor’s Degree is to a “Qualified” rating as a Master’s Degree is to a “Medically Certified” ranking. As such, medically certified interpreters typically charge higher rates and are only required under special extenuating circumstances.

What if I need medical translation services?

Section 1557 now requires qualified medical translators to translate all written translations. Like interpreters, professional translators complete similar education, testing and training programs. Ask us about our medical translations for hospitals, clinics, rehabilitation centers and other healthcare facilities.

I’m not bilingual. If a family member can interpret, why aren’t they considered “competent?”

Qualified interpreters are not only responsible for converting word-for-word conversations, they are also highly aware of specific cultural differences, including circumstances in which an LEP person may not understand a literal interpretation. For instance, in English the phrase, “an arm and a leg” is used to reference the cost associated with a product or service. However, to someone with limited English proficiency, such phrases may seem barbaric, threatening or aggressive.

Interpreters are trained mediums that facilitate conversation. Although they’re present (in person or by video), they are not part of the conversation. Inserting one’s self into the conversation as an interpreter can confuse the LEP patient and potentially put his/her health at risk.

Most importantly, qualified interpreters are educated in the Health Information Portability and Accountability Act (HIPAA). A non-qualified person who is not aware of HIPAA provisions may accidentally put the privacy of the patient and the credibility of the health provider in legal jeopardy.

What if I am a client of IU?

There is no need to worry! All of our contracted interpreters are professionally trained. We provide both qualified and certified medical interpreters for American Sign Language and 200 spoken languages.

What if I am not a client of IU?

Let us know when you need interpreter or medical translation and we will send you a fast, FREE quote.

If your company or organization is interested in a contractual relationship, please call 800-726-9891 or fill out the form to the right.

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Will the Use of  Qualified Interpreter be a Financial Burden?

It’s hard to say, because it depends on the circumstance. If a hospital or government agency has a language services contract, the rates are negotiated. In general, on-site interpreting appointments are priced by the hour, versus by the minute for telephone and video.

However, requesting a certified interpreter versus a qualified interpreter then yes, it would be a higher cost.

What do I need to know about Video Remote Interpreting?

It requires the provider (Interpreters Unlimited or company that provides VRI interpreters) to implement a training program and a high-definition, real-time connection. At IU, our VRI services are HIPPA-compliant, cloud-based and connect you with an interpreter in seconds.

 What if my patient can understand English but their spouse cannot?

Section 1557 is extended to LEP patients and family members, spouse, child or partner who will encounter health services. This applies to Deaf and Hard-of-Hearing persons as well.

What if an LEP patient brings their own interpreter?

It is illegal to require an LEP patient to supply an interpreter. However, the LEP person does have the right to decline language services.

About Interpreters Unlimited

We solve language and transportation needs nationwide.  Our nationwide network of 9,000 contracted linguists and drivers guarantees a 99% fill rate for your next appointment.  We work federal and state government entities, hospitals and medical facilities, schools, corporations, legal firms and insurance companies to bridge the gap when a language barrier is present.

If a patient or client is injured, non-emergency medical transportation services offer a convenient and cost-effective ride to and from doctor’s appointments, physical therapy, depositions or client meetings.

For more information about Interpreters Unlimited and our services, please call 800-726-9891.

About Section 1557

ACA Section 1557 can be classified as a Federal civil rights act, because it prohibits healthcare discrimination on the basis of national origin (which includes immigration status and English proficiency), race, sexual orientation and gender identity. The new legislation applies to health programs, medical appointments and activities that receive federal funding where a person with limited English proficiency or who are Deaf or Hard-of-Hearing has access:

  • Medicaid
  • Medicare
  • Children’s Health Insurance Program (CHIP)
  • Programs created under Title 1 of ACA (state and federal marketplaces)


New 2016 ACA Rules Significantly Affect the Law of Language Access. (2016, May 14). Retrieved October 12, 2016, from /

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