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Treating Limited English Proficient Patients

01.08.13 written by

Treating “LEP” persons present greater challenges to doctors. Individuals who do not speak English as their primary language and who have a limited ability to read, write, speak, or understand English may be Limited English Proficient, or “LEP”. Doctors, who receive federal financial assistance, cannot elect not to treat LEP persons solely because of their limited English language skills. Title VI of the Civil Rights Act of 1964 prohibits discrimination on the basis of national origin in any program that receives Federal financial assistance. Title VI requires that recipients of federal assistance take reasonable steps to ensure meaningful access to their programs and activities by LEP persons. Federal financial assistance includes Medicaid and some Medicare payments. The HHS Guidance specifically excludes from the definition of federal financial assistance doctors who only receive Medicare Part B payments. 

If the doctor receives federal financial assistance, to comply with Title VI it is likely that the doctor will be required to provide some kind of language assistance so that he/she may meaningful communicate with the LEP patient. Doctors may opt to provide an interpreter, telephone interpreter services, or translated documents. However, Title VI prohibits the doctor from requiring a friend or family member of the LEP person from acting as an interpreter. Also, Title VI prohibits the doctor from charging the LEP patient for costs associated with language assistance services. Title VI presents one more challenge to doctors when treating LEP patients.

NOTE: This general summary of the law should not be used to solve individual problems since slight changes in the fact situation may require a material variance in the applicable legal advice.

Laura A. Brady is an attorney with the Healthcare Practice Section at the law firm of Krugliak, Wilkins, Griffiths & Dougherty Co., L.P.A. in Canton.