3 Key Takeaways on CHIP / Medicaid Reimbursement for Language Services
As a language services professional, you understand that interpretation and translation play a crucial role in hospital success, well worth the cost of having a quality program. Even better, state and federal reimbursement may help your organization defray that cost via programs like Medicaid and the Children’s Health Insurance Program (CHIP). The National Health Law Program (NHELP) recently released an issue brief on this topic; here are some key takeaways:
1. All federal funding for Medicaid/CHIP services is contingent on providing quality language services to LEP patients.
To qualify for state or federal reimbursement, a hospital’s language services program must meet the quality standards set forth in relevant federal law:
Civil Rights Act of 1964:
Prohibited Medicaid and CHIP from engaging in national origin discrimination, requiring hospitals to provide limited-English proficient (LEP) patients with interpreters.
Section 1557 of the ACA:
Strengthened the language services requirements found in the Civil Rights Act for HHS-funded health programs and activities. Required qualified interpreters for all LEP patient interactions, posting of notices of nondiscrimination, and gave individuals the right to sue hospitals for disparate impact if an interpreter was not provided.
2. States that choose to reimburse providers for language services can submit a federal request for matching funds.
Medicaid.gov explains that “States are not required to reimburse providers for the cost of language services…still, states do have the option to claim Medicaid reimbursement for the cost of interpretation services, either as medical-assistance related expenditures or as administration.”
The CHIP Reauthorization Act of 2009 also increased federal matching “available for translation and interpretation services provided to “children of families for whom English is not their primary language,” and family members of these children.”
States that expanded Medicaid under the ACA receive significantly higher federal reimbursement for language services “provided to expansion populations as a covered service” – 95% in 2017 and scheduling down to 90% in 2020 and beyond.
States that offer some level of provider reimbursement for language services:
*Sign language interpretation only
3. A quality language services program creates tangible benefits for your organization – especially when reimbursement is available
In addition to legal compliance, NHELP’s piece cites a number of benefits for providers who build a quality language services program. According to the article, language access:
Improve(s) patients’ quality of care
The Joint Commission classifies doctor/patient communication as “a core component of health care,” and the Journal for Healthcare Quality has concluded that adverse events are often caused by hospital staff failing to use an interpreter with every LEP patient.
Enhances understanding of and adherence to medical treatments
The National Center for Biotechnology Information (NCBI) found that LEP patients are:
– 9x more likely to have trouble understanding a medical scenario.
– 4x more likely to misunderstand medication labels.
– 4x more likely to have a bad reaction to medication.
NCBI also found that “quality of interpretation correlates with patient understanding and satisfaction with the encounter.”
Decreases health care costs by reducing adverse health care outcomes
Statistically, non-English speakers, particularly in Latino and Chinese populations, readmit at a significantly higher rate than the general population.8 A review of 10.7 million Medicare patient records revealed that avoidable readmissions cost Medicare $17 billion a year because patients do not:
- Understand their diagnosis.
- Know which medications to take and when.
- Comprehend important information or test results.
- Schedule a follow-up appointment with their doctor.
- Receive adequate care at home.
For LEP patients, a reliable language services program may prevent these misunderstandings.
Interested in partnering with a quality language services provider? Please reach out to our Language Strategy Consultants at email@example.com. CyraCom also offers online signup with no startup fees for our phone and video interpretation services. Click here to get started.