How do I pay for providing medical interpretation services?
The debate about providing medical interpretation services would not be so conflicted if there were available resources. Many health care organizations struggle with providing quality care to limited English proficiency (LEP) persons due to costs. Right now there is no easy answer. NH is one of only 10 states in the nation where Medicaid provides reimbursement for interpretation services. In NH we have found that organizations were not aware of their eligibility to bill on behalf of interpreters. A pilot program to enroll interpreters as providers in Medicaid is showing promising results for those organizations to recoup some of the costs associated with providing interpretation. To be eligible for reimbursement, interpreters need to enroll as Medicaid Providers. They can then receive payment directly from Medicaid or can be reimbursed by the health care institution, which in turn, will bill Medicaid on behalf of the Interpreter. This simplifies the billing process for interpreters. However, the reimbursement rate does not cover actual costs in most cases. Medicaid can not be the only answer, as many more individuals who don't speak English are uninsured. Some facilities have obtained grant support to assist with providing direct language services. Others have developed relationships with volunteers in the communities. Those organizations that offer interpretation resources currently fund interpretation as part of their operating budgets.

The Strategic Plan for Medical Interpretation, funded by the Endowment for Health, highlights the need to emphasize other financing options. One goal of the plan is to "ensure sustainability of medical interpretation by establishing funding streams for services." The plan includes pursuing contributions from health plans, strategies for pooling resources, developing bilingual staff, negotiating statewide contracts and enhanced reimbursement.

The cost of implementing interpretation solutions is a barrier to providing quality care to limited English speakers. However, the risk of lawsuits resulting from errors in communication could end up being much more costly. Participation in the Finance Committee of the Medical Interpretation Advisory Board is a key strategy for organizations interested in identifying funding options for providing language interpretation.

Resources:

• National Health Law Program "Medicaid/SCHIP Reimbursement Models for Language Services", part of the Language Services Action Kit, http://www.healthlaw.org/langaccess/index.shtml.
• Enrolling Interpreters in NH Medicaid, Call EDS at 1-800-423-8303 (in state only) or 603-224-1747 Medical Interpretation Advisory Board: Contact Florentina Dinu at fgdinu@snhahec.org or 895-1514 ext 5.