Welcome to the third and final instalment of our series on the new ACA Section 1557 language access requirements. In Part 1, we explored what the law requires. In Part 2, we looked at the tools and solutions available to help you comply.
In this article, we’ll take it a step further—showing you how the Department of Health and Human Services (HHS) measures compliance, what success looks like in practice, and how to build seamless workflows using the Phrase Localization Platform. You’ll also find practical checklists and integration tips to help bring your strategy to life.
Disclaimer
This guide is for informational purposes only and does not constitute legal, medical, or regulatory advice. While we strive to provide accurate and up-to-date information, compliance with ACA Section 1557 and other healthcare regulations requires careful interpretation of the law and professional guidance. Healthcare providers and organizations should consult with qualified legal counsel, compliance specialists, or medical professionals before implementing any language access policies or strategies. Phrase does not provide legal, medical, or clinical advice, and reliance on the information in this guide is at your own risk.
How HHS measures compliance: Key metrics for healthcare providers
To avoid penalties and ensure equitable care, healthcare organizations must track six core metrics that demonstrate they are providing meaningful access to patients with Limited English Proficiency (LEP).
| Key metric | What you need to track | HHS evaluation criteria | How Phrase can help | Pro tips for success |
| Language assistance utilization rates | Number of LEP patients served; Frequency of interpreter requests (onsite, phone, video, ASL); Number of translated documents accessed/downloaded. | HHS compares utilization rates to LEP patient demographics. Low utilization may indicate lack of accessibility or awareness. | Provides advanced analytics to monitor language service usage; Centralized platform consolidates all translation activities for easier reporting. | Use automated tracking tools within EHR systems or patient portals to monitor interpreter and translation requests. |
| Timeliness of language assistance services | Average wait time for an interpreter (in-person, phone, video); Turnaround time for document translations; Speed of website content updates in multiple languages. | Delays in interpreter availability or document translation can be considered a barrier to care, violating meaningful access standards. | Phrase Orchestrator automates translation workflows, reducing turnaround time; Real-time collaboration speeds up review processes. | Ensure immediate access to emergency interpretation services within 5 minutes; High-priority documents should be translated within 24–48 hours. |
| Accessibility of translated materials & notices | Percentage of vital documents available in the top 15 languages; Visibility of language assistance notices; Accessibility of multilingual website pages & digital content. | HHS audits the availability and accessibility of translated materials. If translations are hard to find, compliance may be questioned. | Seamless CMS & digital platform integrations ensure translated materials are updated and accessible; In-context editor improves translation clarity. | Use analytics tools to measure document access rates; Conduct patient surveys to ensure they know about language access services. |
| Patient satisfaction & complaint resolution | LEP patient feedback on language access services; Number of complaints related to language barriers; Speed of complaint resolution. | Repeated complaints about language barriers may trigger compliance reviews. Slow resolution times may indicate inadequate services. | Auto LQA and Phrase QPS ensure high quality translation, reducing patient complaints; Feedback integration improves ongoing language services. | Implement multilingual patient satisfaction surveys; Assign a Language Access Coordinator to oversee complaint resolution. |
| Staff training & compliance knowledge | Percentage of staff trained on ACA Section 1557 & language access policies; Frequency of staff training; Staff proficiency in translation & interpretation tools. | HHS expects ongoing staff training. Lack of regular training is a major compliance red flag. | User-friendly interface simplifies translation management; Resource hub offers continuous training support for best practices. | Host quarterly refresher courses for frontline staff; Use e-learning modules for ongoing compliance training. |
| Digital & Telehealth Compliance | Percentage of telehealth services offering interpretation options; Availability of translated patient education materials; AI & human-reviewed translation use in telehealth documentation. | HHS is scrutinizing telehealth platforms for language accessibility. If patients cannot access interpreters or translated materials online, compliance may be at risk. | Secure localization maintains patient confidentiality; Scalable solutions support rapid expansion of multilingual telehealth services. | Integrate multilingual chat support and real-time interpretation services into telehealth platforms; Ensure telehealth visit summaries & instructions are available in multiple languages. |
By integrating the Phrase Localization Platform into their operations, healthcare providers can effectively meet HHS compliance metrics, ensuring that language assistance services are timely, accessible, and of high quality.
A day in the life of a compliant healthcare provider: How seamless language access works in practice
To illustrate what full compliance with ACA Section 1557 looks like in the real world, let’s walk through a hypothetical day in a busy urban hospital. We’ll see how a well-implemented language access strategy ensures every patient—regardless of their primary language—receives equitable, timely, and high-quality care.
Morning: Emergency room visit
8:15 AM – Mrs. Nguyen, a Vietnamese-speaking patient, arrives at the ER with severe chest pain. She does not speak English fluently.
How a compliant provider responds
- Identifying language needs: The triage nurse asks a screening question: “What language do you prefer to communicate in?” Mrs. Nguyen points to an “I Speak” language identification card.
- Providing an interpreter: The nurse uses a telehealth-integrated interpreting system to connect with a Vietnamese-speaking medical interpreter within 30 seconds.
- Translating critical documents:
- The hospital has a workflow for translating standardized discharge instructions, which are commonly needed in multiple languages.
- If customized discharge notes are required, a hospital language services team or external translation provider must review and translate them manually before release.
- A bilingual staff member or human translator reviews AI-assisted translations to ensure medical accuracy before documents are given to the patient.
Compliance metrics met
- Timely language assistance: An interpreter was provided within minutes.
- Accurate and verified translations: Standardized multilingual materials were available, and custom translations were reviewed by a qualified human expert.
- Accessible information: Mrs. Nguyen left with clear aftercare instructions in Vietnamese, reducing risks of miscommunication.
Midday: pharmacy visit for prescription pickup
11:45 AM – Mr. García, a Spanish-speaking patient, arrives at the hospital’s pharmacy to pick up new diabetes medication.
How a compliant provider ensures language access
- Language-specific prescription labels: The pharmacist checks the patient’s record and sees Spanish as the preferred language. The hospital’s electronic prescription system includes multilingual capabilities, generating a Spanish prescription label when applicable.
- Ensuring medication understanding:
- If the system does not generate translated medication guides automatically, the pharmacist requests an approved translation from the hospital’s language access team.
- If immediate assistance is needed, the pharmacist calls a video interpreter to review instructions with the patient.
- Any ad hoc translations (for example, handwritten instructions) must be formally reviewed by a bilingual pharmacist or translation specialist to maintain compliance.
Compliance metrics met
- Translated vital documents: Standard prescription labels and medication guides were available in Spanish.
- On-demand interpretation: A trained interpreter ensured patient understanding, preventing errors.
Afternoon: Telehealth follow-up appointment
2:30 PM – Mrs. Hassan, a Somali-speaking patient, logs in for a post-surgical telehealth appointment.
How a Compliant Provider Ensures Digital Language Access
- Integrated language services:
- The hospital’s Electronic Health Record (EHR) system flags patients with LEP needs, ensuring staff are aware before the appointment.
- The telehealth scheduling system allows for pre-booking of a remote interpreter, so a Somali-speaking interpreter joins automatically at the start of the visit.
- Multilingual patient portal:
- The hospital’s web team maintains translated content for common post-surgical care instructions in Somali and other frequently spoken languages.
- If specific patient instructions require customization, the language services team translates them manually before uploading them to the portal.
Compliance metrics met
- Digital language access: Telehealth systems accommodate language preferences automatically.
- Accurate, timely translations: Commonly needed documents were pre-translated, while custom instructions were reviewed by a human translator before release.
End of day: Compliance review and reporting
5:00 PM – The hospital’s Language Access Coordinator reviews daily compliance reports and translation requests.
How a compliant provider racks and Improves Language Access
- Real-time monitoring:
- Interpretation service usage is logged, showing how many requests were made, which languages were most in demand, and average wait times.
- Website traffic reports highlight which translated documents were accessed and which ones may need updates.
- Translation quality control:
- Any discrepancies between AI-generated translations and human-reviewed edits are flagged for improving translation workflows.
- The hospital’s Translation Memory is updated with new medical terminology to ensure consistency in future translations.
- Ongoing staff training:
- Any missed compliance targets (e.g., delayed interpreter response times) are flagged for staff retraining.
- The hospital conducts periodic audits to ensure frontline staff understand how to access language services efficiently.
Compliance metrics met
- Tracking language assistance requests: Reports log interpretation usage and translation activity.
- Quality control: Human oversight ensures that AI-assisted translations meet compliance and accuracy standards.
- Continuous improvement: Data-driven adjustments enhance future compliance and efficiency.
While it may seem like ‘just another day’, hopefully this scenario has helped show just how complex the process of ensuring language access compliance can really be for healthcare providers.
Hospitals must proactively plan for translation and interpretation needs, ensuring that both standardized and customized content is accessible, accurate, and timely for LEP patients.
The bottom line: Compliance leads to better patient outcomes
By leveraging Phrase’s AI-powered translation tools, integrated interpretation services, and real-time compliance tracking, healthcare providers can:
- Reduce risks of miscommunication
- Improve patient satisfaction and health outcomes
- Meet all HHS compliance metrics with ease
A fully compliant language access strategy isn’t just about following regulations—it’s about ensuring every patient, regardless of language, receives equitable and effective care.
What’s next?
Finally, now that we’ve seen how compliant healthcare organizations operate, we’ve gathered the following resources to help you implement these strategies effectively.
Checklist: Key Steps to ACA Language Access Compliance in 2025
Ensure your organization meets the latest compliance standards with this actionable checklist:
- Develop a Language Access Plan (LAP):
- Assess the language needs of your patient population.
- Establish protocols for providing interpretation and translation services.
- Assign a coordinator to oversee language access initiatives.
- Translate Vital Documents:
- Identify and prioritize documents critical to patient care and rights.
- Utilize both AI-powered translation tools and human review to ensure accuracy.
- Regularly update translations to reflect any changes in content or regulations.
- Implement Website Translation Best Practices:
- Ensure your website is easy to navigate in the primary languages of your service area.
- Translate key sections, including patient resources and contact information.
- Optimize multilingual content for search engines to enhance accessibility.
- Establish Mechanisms for Language Assistance Service (LAS) Requests:
- Provide clear instructions for patients to request language assistance.
- Ensure LAS requests can be made across various platforms, including online, by phone, and in person.
- Monitor and respond promptly to LAS requests to maintain trust and compliance.
- Train Staff on Compliance and Technology:
- Conduct regular training sessions on ACA Section 1557 requirements.
- Educate staff on utilizing translation and interpretation tools effectively.
- Foster cultural competency to improve patient interactions and care.
Integration Guide: How to Connect Phrase with Your Existing Tools
Seamlessly incorporate Phrase into your current systems to enhance language access services:
- Explore Available Integrations:
- Phrase offers over 50 integrations with various platforms, including Content Management Systems (CMS), marketing automation tools, and customer support software.
- Set Up Connectors:
- Utilize connectors to pull content from your existing systems into Phrase for translation.
- Ensure that connectors are configured to handle the specific content types and workflows of your organization.
- Implement Plugins:
- For systems that support it, use plugins to push content directly into Phrase, streamlining the translation process.
- Configure plugins to automate the sending and receiving of content, reducing manual intervention.
- Customize Workflows:
- Leverage Phrase’s workflow customization to align with your organization’s processes.
- Set up automated steps for translation, review, and approval to ensure efficiency and compliance.
- Monitor and Optimize:
- Use Phrase’s analytics to track translation progress and identify areas for improvement.
- Regularly review integration performance to ensure seamless operation and address any issues promptly.
For detailed instructions and support, refer to Phrase’s Integration Support Center.
It’s important to remember that compliance is always evolving. By utilizing these resources and integrating Phrase into your operations, your organization can effectively meet ACA Section 1557 compliance requirements, ensuring equitable and accessible care for all patients.
Learn how Phrase can support your multilingual compliance efforts
Disclaimer
This guide is for informational purposes only and does not constitute legal, medical, or regulatory advice. While we strive to provide accurate and up-to-date information, compliance with ACA Section 1557 and other healthcare regulations requires careful interpretation of the law and professional guidance. Healthcare providers and organizations should consult with qualified legal counsel, compliance specialists, or medical professionals before implementing any language access policies or strategies. Phrase does not provide legal, medical, or clinical advice, and reliance on the information in this guide is at your own risk.
