The new reality of language access in healthcare

If you work in healthcare, you know how critical clear communication is. When patients can’t fully understand their doctors, prescriptions, or medical paperwork, it doesn’t just cause confusion—it can lead to misdiagnoses, delayed treatments, and poor health outcomes. That’s exactly why language access is such a big deal.

And now, it’s no longer just a best practice—it’s the law.

As of July 5, 2024*, healthcare providers and organizations that receive federal funding must follow new, stricter language access requirements under Section 1557 of the Affordable Care Act (ACA). These regulations aim to eliminate language barriers, ensuring that people with Limited English Proficiency (LEP) get the care they need—without confusion, delay, or risk.

(*While the final rule became effective on July 5, 2024, certain provisions have extended compliance deadlines. Specifically, covered entities with fewer than 15 employees have until July 5, 2025, to comply with Section 1557 requirements. Larger organizations are expected to comply by the initial effective date.)

So, what does this mean for you?

If your organization accepts Medicare, Medicaid, or other federal funding, you’re legally required to provide qualified interpreters, accurate translations, and effective communication for LEP patients. And it’s not enough to simply “do your best”—there are specific steps you need to take to comply.

This guide will break it all down for you—what’s changing, what’s required, and most importantly, how you can make compliance easier using modern language technology, AI-powered translation tools, and streamlined processes.

The big changes you need to know (Effective July 2024)

1. “Meaningful Access” is now a legal standard

If your patients can’t fully understand their healthcare provider, they’re not getting “meaningful access” to care. Under the new law, providers must take reasonable steps to ensure every patient gets language assistance at no cost.

Common scenarios where this applies:

• A patient picking up a prescription—They must be able to read and understand dosage and side effects.
• An ER visit—A patient must understand what’s happening, even in high-pressure situations.
• Applying for health insurance—Patients must be able to navigate forms and policies.
• A doctor’s appointment—They must have access to an interpreter if needed.

Providers can’t assume that just because someone speaks “some” English, they don’t need help.

2. Only qualified interpreters and translators can be used

Gone are the days of relying on bilingual staff, family members, or Google Translate. The new law requires qualified professionals for both spoken and written language services.

• Qualified interpreters must be fluent in both English and the patient’s language, trained in medical terminology, and follow confidentiality standards.
• Qualified translators must ensure written medical materials are accurate, clear, and culturally appropriate.

Simply put—no more ad-hoc solutions.

3. Machine translation must be verified by a human expert

AI-powered translation tools are great, but they aren’t perfect. If an organization uses machine translation (MT) to translate vital documents, a qualified human translator must review and correct the content before it’s given to a patient.

Why? Because mistakes in medical translations can be dangerous. Imagine a mistranslation on a prescription label or surgical consent form—the consequences could be life-threatening.

The bottom line: AI is a tool, not a solution. You still need human oversight to ensure accuracy.

4. Websites and digital content must be multilingual

Patients must be able to find translated healthcare information online. This means organizations need to:

• Post in-language webpages—Not just a link to a Google translation.
• Provide translated vital documents—Forms, policies, and patient instructions must be available in the most commonly spoken languages.
• Ensure LEP patients can easily access info about language assistance services.

This applies to all digital touchpoints—from patient portals to appointment scheduling platforms.

Why compliance can be a challenge

While these updates are well-intentioned, compliance can feel like a logistical nightmare for healthcare organizations, especially when:

• Staff aren’t trained on language access laws.
• Interpreters and translators are expensive and hard to schedule.
• Machine translation isn’t always reliable without human review.
• Telehealth and digital platforms aren’t optimized for multiple languages.

Many hospitals and clinics currently rely on third-party interpreting services like Martii, Jeenie, and Boostlingo, which provide remote medical interpreters. While helpful, these solutions don’t address website translation, AI-assisted workflows, or patient self-service tools.

That’s where modern localization solutions—like Phrase—can make a real impact.

What’s next?

In the next sections, we’ll look more closely at:

• How to choose the right language access solutions for 2025
• Step-by-step strategies for full compliance
• How healthcare providers can track success and meet HHS standards
• Practical tools and resources to simplify the process

Staying compliant doesn’t have to be overwhelming—with the right approach, you can meet regulatory requirements while improving patient experience and outcomes.

The “Meaningful Access” mandate: What it really means for healthcare providers

To be clear, while the Department of Health and Human Services (HHS) defines “meaningful access” as taking reasonable steps to provide timely, accurate, and effective communication to LEP individuals. While failure to provide such access can be considered discriminatory, the emphasis is on the reasonableness and effectiveness of the steps taken, considering factors like the entity’s resources and the nature of the communication.

When is language access absolutely essential?

While all healthcare interactions should meet language access requirements, there are some situations where the risks of miscommunication are especially high.

Making meaningful access work in the real world

So, how can healthcare organizations meet these new standards without adding excessive administrative burdens?

The good news is—modern technology and smart integrations can make compliance much easier.

Here’s what successful organizations are doing:

• Using a mix of qualified human translators and AI-powered translation tools for efficiency.
• Integrating language access into their EHR (Electronic Health Records) and telehealth platforms.
• Partnering with modern interpretation services that provide on-demand video and phone interpreters.
• Automating website and document translation workflows to keep up with changing regulations.

For example, Phrase provides end-to-end translation solutions that can help organizations streamline compliance while keeping costs down. With AI-powered workflows, human review checkpoints, and easy integration into existing healthcare platforms, organizations can meet these new language requirements without overwhelming their teams.

What’s next?

Now that you understand what “meaningful access” means and how to avoid compliance pitfalls, the next step is to explore the best language access solutions available in 2025.

• Which medical interpretation services are the best fit for your organization?
• How can you integrate translation tools into your existing systems?
• What strategies make compliance easier—and more cost-effective?

These traditional platforms have been instrumental in facilitating real-time communication between healthcare providers and LEP patients. However, as the demand for comprehensive language services grows, there’s a need for more integrated solutions that encompass not only interpretation but also translation of vital documents and digital content.

How Phrase enhances language access

The Phrase Localization platform goes beyond traditional interpretation services, with capabilities designed to meet the multifaceted language needs of healthcare organizations.

Practical examples of Phrase in action

Several organizations have successfully leveraged Phrase to overcome language barriers and enhance communication:

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By integrating Phrase into their operations, healthcare organizations can enhance their language access services, ensuring compliance with regulations and, more importantly, providing equitable care to all patients, regardless of language barriers.

Step-by-Step Compliance Guide: Meeting ACA Section 1557 Language Access Requirements

Healthcare organizations need a clear, actionable strategy to comply with the updated ACA Section 1557 language access requirements. In the following section, we’ll walk you through each step, helping you ensure compliance while improving patient communication and care.

You can use the following sections of this guide as a checklist to help verify your organization’s compliance efforts.

Step 2: Translate and update vital documents

Under ACA Section 1557, all critical patient-facing documents must be available in multiple languages.

How to ensure accuracy and compliance

• Prioritize the most common languages spoken by your patients. Use census data, EHR records, and community surveys to determine which languages are needed.
• Use AI-powered translation tools (like Phrase) to streamline document translation—but ensure a human translator reviews all critical content.
• Maintain consistency with translation memory and terminology management to ensure accurate medical terms across all materials.
• Review translations annually to update medical, regulatory, or procedural changes.

Step 4: Establish a system for Language Access Service (LAS) requests

Patients must be able to request language assistance easily—whether online, by phone, or in person.

How to set up a request system:

• Add a “Request an Interpreter” button to your website: Patients should be able to request spoken or sign language interpreters when booking appointments.
• Train Frontline Staff: Receptionists, nurses, and scheduling teams must know how to access LAS services quickly.
• Use a dedicated language access hotline: A direct phone line ensures fast, 24/7 interpreter access.
• Ensure multi-platform access: Patients should be able to request services via EHR systems, telehealth platforms, or patient portals.

Next steps: Stay ahead of compliance requirements

Staying compliant with ACA Section 1557 doesn’t have to be overwhelming. By integrating AI-powered translation tools, automated workflows, and trained interpreters, healthcare providers can make compliance simple and scalable.

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.

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.

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. 

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.

Integration Guide: How to Connect Phrase with Your Existing Tools

Seamlessly incorporate Phrase into your current systems to enhance language access services:

1. Explore Available Integrations:
   • Phrase offers over 50 integrations with various platforms, including Content Management Systems (CMS), marketing automation tools, and customer support software.
2. 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.
3. 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.
4. 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.
5. 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.

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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.