New Oregon Requirements for Health Care Interpretation

On July 1, 2022, a registry for health care interpreters will be readily available here in Oregon. This work is the result of House Bill 2359, passed during the 2021 legislative session. The bill is the first in what should be a series of improvements to the field of health care interpretation to assist providers with access to interpreter services for their patients.

In general, the bill called for providers to use a qualified or certified health care interpreter (HCI) from Oregon’s central registry. As is the general practice of health care providers, interpreter services should be arranged for when providing health care services to a person with limited English proficiency, who prefers to communicate in a language other than English, or who communicates in signed language. Exceptions to this new state requirement will require at least one of the following:

• Provider has documented proficiency in the language
• Provider has made good faith effort to obtain a HCI from the registry
• The patient declined the interpreter offered at no cost and instead chooses a different person to provide interpretation (such as a family member)

Key Dates

• July 1, 2022: On-site interpreters must be obtained using Oregon's central registry
• July 1, 2023: Both on-site and remote interpreters must be obtained using Oregon's central registry

Documentation Requirements

Providers are expected to maintain records for each encounter that uses an interpreter starting July 1, 2022, and be ready by September 1, 2022, to provide the Oregon Health Authority with evidence of documentation if requested. For each encounter that used an interpreter, providers should be documenting the following: full name of HCI, HCI central registry number, and language interpreted.

Providers that will be communicating in the patient’s preferred language instead of using an interpreter will need to  maintain some documentation of evidence of their proficiency.

If a patient declines the interpreter, that too should be documented clearly that they were offered an interpreter at no cost and chose a different interpreter.

If a provider is unable to find a provider that is in the registry, the provider will want to  document the good faith efforts taken. OHA has not released guidance on what constitutes good faith efforts. Provider offices should develop policies about interpreter services and steps taken to use the central registry.

Protective Equipment Requirements

For onsite interpreter services, provider offices will want to ensure they are offering HCIs appropriate personal protective equipment (i.e., face masks) similar to what they make available to their patients at no cost. 

Reimbursement

The new law does not provide any changes to reimbursement. Coordinated Care Organizations in Oregon will continue to provide interpreters at their cost and Oregon Health Plan Open Card will continue to provide a flat rate of $60 for interpreters from the registry. Other health plans are not required to cover the costs of interpreters.

Some practices may be eligible for the Disability Access Credit to help offset the cost of providing American Sign Language interpretation services.

Other Considerations

There are still a few unanswered questions for providers and patients about accessing the registry. The first question that is starting to be addressed by the Oregon Health Authority is the question of provider offices using interpreter service companies that can provide online services in a cost-effective manner. OHA is permitting a one-year transition period for service companies to take steps to register interpreters. What provider offices should be doing is documenting the use of the service company as part of their documentation requirements.

Another question is whether OHA will permit HCIs who appear in the Office of Inspector General exclusion lists for Medicare and Medicaid services to remain in the registry. For now, OHA will not be requiring any background checks to streamline the ability to have an HCI to sign up with the registry. Provider offices should be mindful of this issue and plan to conduct their own checks of the exclusion lists and document those checks before engaging an HCI from the registry. Provider offices that work with interpreter service companies will want to ensure that those companies are providing those checks of exclusion lists.

Providers should keep track of any ongoing issues related to the registry and details regarding the cost of interpreter services. There is more work to be done to help providers and patients access interpreter services in an easy and cost-effective manner and having good documentation of any issues will help lawmakers improve the program.

Resources

• Oregon Health Care Interpreter Program Changes Fact Sheet
• Oregon Health Plan Fee for Service Interpreter Reimbursement
• Disability Access Credit
• Rule Text
• House Bill 2359

Disclaimer: This material is for informational purposes only and is not intended to constitute legal advice. The information, examples, and suggestions presented in this material (though reliable) should not be construed as legal or other professional advice. Before applying this information in legal situations, we recommend you consult with legal counsel or other professional advisors.