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Nondiscrimination, Language Assistance Rule Final

A May 13 final rule from the U.S. Department of Health and Human Services (HHS) carries out nondiscrimination protections mandated by the Affordable Care Act (ACA) and establishes new requirements for language assistance for people with limited English proficiency (LEP)

The Nondiscrimination in Health Programs and Activities final rule protects individuals in federally funded health programs from discrimination based on race, color, national origin, age, disability, sex, pregnancy, gender identity, and sex stereotyping.

It also enhances language assistance for people with LEP. Under the rule, hospitals and other covered entities are required to take reasonable steps to provide meaningful access to individuals with LEP, including the use of qualified interpreters. The rule provides flexibility in how these entities might demonstrate the steps taken to achieve compliance, allowing for the development of context-specific plans based on the communities each covered entity serves. Further, HHS encourages covered entities to develop language access plans to ensure preparedness in providing such services.

The rule also defines two types of qualified interpreters: one for individuals with LEP and one for individuals with a disability. These new standards address the need for covered entities to provide effective, accurate, and impartial interpreters and translators.

Earlier this year, the association’s Equity Leadership Forum shared with The Joint Commission recommendations to improve equity, including the need to address language barriers. The Forum’s subcommittee on language access recommended alignment with HHS’ plan to shift the legal standard for the type of interpreters from “competent” to “qualified” to reduce the risk of medical errors, and recommended metrics organizations can follow when designing language access plans.

Contact Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Maryellen Guinan is a principal policy analyst at America's Essential Hospitals.

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