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How Does Medicare Handle Language Barriers in Home Health Care?
Date Updated: December 13, 2024
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Dr. Brindusa Vanta is a health care professional, researcher, and an experienced medical writer (2000+ articles published online and several medical ebooks). She received her MD degree from “Iuliu Hatieganu” University of Medicine, Romania, and her HD diploma from OCHM – Toronto, Canada.
Medicare handles language barriers in home health care by only certifying agencies that meet specific standards and federal requirements. Medicare doesn't pay for translation services, but Medicare-certified home health care agencies offer free interpreter services to patients with limited English proficiency.
Background on Limited English Proficiency in the United States
Most Americans speak only English in their day-to-day lives or have high English-speaking abilities, according to the 2018–2022 American Community Survey. However, the nation still has many non-English speakers; as of 2019, almost 68 million people used a different language at home. The most common non-English languages used in the United States include Spanish, various dialects of Chinese and Tagalog. While many individuals speak adequate English alongside their native language, around 8% of people in America have limited English proficiency as of 2021. This barrier represents around 25.7 million individuals nationwide.
Numerous studies indicate an array of problems concerning language barriers in health care. Research also suggests language issues create larger workloads for home health care professionals. However, per Title VI of the Civil Rights Act, agencies can’t refuse to provide home health care for people with limited English skills or discriminate against them.
Legal Requirements to Provide Language Assistance
Any medical provider that accepts federal funding, such as Medicare-certified home health care agencies, must offer free interpreter services to patients with limited understanding and use of English. Such services ensure meaningful access to health care.
Guidance from the U.S. Department of Health and Human Services states that federally funded providers must assess the language abilities of people living in their service area and create a plan for meeting their needs. They must offer oral interpretation and consider whether individuals need written translations. However, agencies don’t need to employ bilingual staff; interpretation may take place in person, through suitably qualified staff or contracted interpreters, or over the telephone using external language services. The U.S. Department of Health and Human Services’ 2023 Language Access Plan contains steps to further improve reasonable access for LEP individuals.