The US Department of Health and Human Services (HHS) has finalized an update to Section 1557 of the Affordable Care Act, with a new effective date of July 5, 2024 . Some provisions have extended deadlines, but the core requirements are now in force.
These rules apply to almost every medical practice in the US, as they cover any entity that receives federal financial assistance, including those that participate in Medicare Part B or Medicaid .
What’s Required: Your Compliance Checklist
The updated rule moves beyond general principles to set specific, actionable standards for providing “meaningful access” to patients with Limited English Proficiency (LEP) . The following table summarizes the core requirements:
| Requirement | Key Details & Action Steps |
|---|---|
| Provide Free Language Assistance | Offer translation/interpretation at no cost to the patient . |
| Use Qualified Professionals | Use interpreters/translators fluent in both languages, trained in medical terminology, and bound by confidentiality. Bilingual staff or family members are not sufficient unless in an emergency or at the patient’s specific request (with proper consent) . |
| Issue Annual & Embedded Notices | Provide an annual Notice of Availability for language services. Notices must be in English and the top 15 non-English languages in your state(s) of operation . |
| Include Notices in Core Documents | The Notice of Availability must be attached to key documents like HIPAA privacy practices, intake forms, consent forms, discharge papers, and billing statements . |
| Ensure Human Oversight of Technology | While machine translation (like Google Translate) can be used, the output for critical documents must be reviewed and corrected by a qualified human translator before being given to a patient . |
| Establish Written Procedures | Develop and maintain a formal Language Access Plan. Entities with 15 or more employees must also designate a Section 1557 Coordinator . |
Why “Meaningful Access” is the New Standard
The central goal of the updated rule is to ensure “meaningful access” for LEP individuals. This legal standard means patients must be able to fully understand and participate in their healthcare, just like an English-speaking patient . This is critical in high-stakes situations such as:
Emergency Room Visits: Miscommunication can be life-threatening. Qualified interpreters must be available 24/7 .
Understanding Medications: Mistakes in translated dosage instructions or side effects can lead to serious harm .
Doctor’s Appointments & Telehealth: Patients must fully grasp diagnoses, treatment plans, and follow-up care .
Signing Consent Forms: Patients need to understand what they are agreeing to, whether for a procedure, a medical power of attorney, or a living will .
The Risks of Non-Compliance
Failing to adhere to these requirements is not just an operational misstep—it is considered discrimination under federal law . The consequences for non-compliance can include:
Federal Penalties and Investigations by HHS’s Office for Civil Rights (OCR).
Loss of Federal Funding, including Medicare and Medicaid payments.
Increased Legal Exposure, as courts have consistently recognized a private right of action for individuals to file lawsuits under Section 1557 .
Patient Safety Risks and damage to community trust.
Next Steps for Your Practice
As a practice manager, now is the time to take proactive steps to audit and update your protocols.
Conduct an Audit: Review your current language access services, vendor contracts, and patient documents.
Develop Your Plan: Create or update your formal Language Access Plan and designate a 1557 Coordinator if required .
Train Your Staff: Ensure all frontline staff are trained on the new procedures for identifying LEP patients and obtaining qualified language services .
Review Your Documents: Audit all “significant” communications and ensure the Notice of Availability is included and translated into the required languages .
Disclaimer: The information provided in this post is for general informational purposes only and was accurate at the time of publication. Regulations and guidelines are subject to change. For the most current information and advice tailored to your specific situation, please contact our team directly.
