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Qualified Interpreters | What Does Section 1557 of the ACA Require?

Published on November 21, 2017 by Graham Newnum

Section 1557 Qualified Interpreters

Is your organization in compliance with Section 1557's requirements for qualified interpreters?

In mid-2016, the US Department of Health and Human Services (HHS) issued a rule to help medical and insurance providers comply with Section 1557. A key change in HHS’s ruling modifies the standard for interpreters in healthcare, replacing “competent” with “qualified” as the expectation for anyone providing interpretation services.

In the wake of this ruling, many providers are looking for a workable definition of "qualified" interpreters. According to Section 1557 - and the subsequent clarifying HHS ruling - qualified interpreters should be:


By changing verbiage on interpreters from “competent” to “qualified,” HHS placed emphasis on interpreters needing some form of qualification. They drew a distinction between multilingual individuals and those who have undertaken specific training and had their proficiency tested.

As the leading provider of interpretation services to healthcare, CyraCom offers our partners assessment and training services to ensure your staff interpreters meet Section 1557's testing and training requirements.


HHS's ruling specifically warned providers not to rely on bilingual staff unless their stated job duties include interpreting. Qualified interpreters must also be:

  1. Proficient in speaking and understanding both spoken English and at least one other spoken language, including any necessary specialized vocabulary, terminology, and phraseology, and
  2. Able to effectively, accurately, and impartially communicate directly with individuals with limited English proficiency in their primary languages.

The ruling also prohibited the use of minor family members (except in an emergency) and adult friends and family (unless the patient specifically requests it). Qualified interpretation must be done by professionals.

CyraCom provides all of our employee interpreters with 120 hours of in-person, standardized classroom training focused on healthcare interpretation. We continue to monitor interpreters regularly for quality and professionalism.


HHS has stated that one of their standards for auditing a hospital’s language services programs will deal with “ethical principles such as client confidentiality.” In practice, this means training interpreters to protect the privacy of those they serve and monitoring their work to ensure any ethical breach – whether deliberate or accidental – is caught and corrected.

CyraCom's large-scale US interpreter center model enables us to comply with security and confidentiality protocols. We utilize a secure process to ensure only authorized personnel can enter, employ both physical and electronic surveillance, and supervise adherence to regulations like Section 1557.

Download our complete Section 1557 whitepaper for a complete overview of the law's language access requirements:

Section 1557 Guide Compliance