Who Pays for Medical Interpreters?

Federal law requires medical practices to use interpreters. Title VI of the Civil Rights Act requires interpreters for all patients with limited English proficiency (LEP) based on national origin who receive federal financial assistance except for Medicare Part B. Just as in the case of wheelchair accessibility for disabled persons, not providing interpreters when needed is discrimination and is illegal.

The problem is that in most states, interpreting services are a legal mandate with no funding. https://www.scstatehouse.gov/code/t01c013.php Medicaid, Medicare, and most private insurers don’t pay for interpreter services. The fact that professional interpreter services are not reimbursed has resulted in a serious problem. A lot of medical professionals choose to rely on the following people as ad hoc interpreters to avoid paying for a professional:

  • Family
  • Friends
  • Bilingual staff

Why are they unqualified to interpret?

  • Family is biased and tend to omit information they deem unnecessary
  • Parents and children often won’t admit embarrassing issues in front of each other or friends (drug history, sexual problems, domestic violence, etc.)
  • It’s against the law to use a person under the age of 18 to interpret
  • Staff, family, and friends are unfamiliar with technical medical terminology in the LEP’s language
  • Unfamiliar with interpreter code of ethics

These untrained, unprofessional ad hoc interpreters, especially children, create great serious risk in the following areas:

  • patient dissatisfaction
  • miscommunications
  • medical errors
  • unnecessary testing
  • possible malpractice liability

Please refer to a previous blog that tells the story of Willie Ramirez. One misunderstood word resulted in a $71 million malpractice suit. This case is a strong argument for paying for the interpreter yourself if no one else will. When you consider it as a $200 investment, the interpreter cost is worth it. The alternative could be a multimillion-dollar lawsuit, expensive legal fees, and the mental and emotion toll of litigation.  When preparing your annual budget, create a new line item for professional interpreting services.

The following three national organizations provide interpreter certifications. Certified professional interpreters are fluent in their languages, knowledgeable in complicated medical terminology, and thoroughly understand ethics.

  1. Certification Commission for Healthcare Interpreters (http://www.cchicertification.org
  2. National Board of Certification for Medical Interpreters (http://www.certifiedmedicalinterpreters.org)
  3. The Registry of Interpreters for the Deaf provides certification for deaf interpretation (http://www.rid.org)

As noted in the case of Willie Ramirez, a simple error or omission in interpreting can result in millions of dollars in fines and unnecessarily devastate a person’s life. Even if there isn’t a reimbursement for federally mandated interpreting services, the value comes from avoiding a huge lawsuit and a guilty conscience. 

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