Resolution 23: Physician Reimbursement for Interpreter Services

Introduced by:  Western Carolina Medical Society

Referred to:        Reference Committee No. 1 – Timothy M. Beittel, MD, Chair

WHEREAS, the immigrant population in North Carolina grew 67.2% between 2000 and 2010; and

WHEREAS, most immigrants have limited English proficiency and speak English “less than well” according to US census data; and

WHEREAS, clear communication between patient and provider is responsible for better patient compliance and essential for positive health outcomes; and

WHEREAS, Title VI of the Civil Rights Act of 1964 requires that limited English proficiency patients have access to “culturally and linguistic appropriate services” at no cost to the patient; and

WHEREAS, interpreter services represent a significant and burdensome cost for healthcare providers; and

WHEREAS, in 2000, the Centers for Medicaid and Medicare Services reminded states that they could include language services as an administrative or optional covered service in their Medicaid and State Children’s Health Insurance Programs, and thus directly reimburse providers for the costs of these services for program enrollees; and

WHEREAS, North Carolina has been a leader in addressing health disparities as evidenced by the NC Health & Wellness Trust Fund and the NC Office of Minority Health; and

WHEREAS, currently, 12 U.S. states and the District of Columbia offer reimbursement for interpreter services; therefore be it

RESOLVED, That the North Carolina Medical Society seek to establish reimbursement of a reasonable rate to physicians in North Carolina for interpreter services for patients who are covered by both private insurance companies including Blue Cross Blue Shield and United Healthcare and Medicaid and State Children’s Health Insurance Programs; and be it further (action)

RESOLVED, That the North Carolina Medical Society supports physician reimbursement for interpreter services that covers the entire patient encounter from their check-in until they have completed the check-out process, and be it further (policy)

RESOLVED, That the North Carolina Medical Society supports establishment of a certification/credentialing exams for medical interpreters in conjunction with University of North Carolina Greensboro at the earliest opportunity, and be it further (policy)

RESOLVED, That the North Carolina Medical Society supports development of a medical interpreter certification process to address the needs of the Spanish-speaking population first, and supports development of a timeline for the development of medical interpreter certification process for other languages based on population demands. (policy)

Fiscal Note:  Estimated additional budget impact:  $20,000.  Current resources will be allocated based on the priorities of the Society and the NCMS budget.

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  • Sandra Brown

    I will take the contrarian approach and oppose this resolution. The case of Spanish language translation parallels closely with that of sign language interpretors. That system is prone to high levels of abuse. If the interpetor travels to the office but the patient no-shows, the interpretor still expects to get paid. But will the insurance company reimburse the doctor since there was no billable service to the patient? Probably not. Also, collusion between patients and interpretors is possible whereby the patient could bring a family member to translate, or actually the patient may speak and understand English reasonably well but demand an interpreter who then kicks back part of the fee to the patient. What if the interpretor charges more than insurance reimburses? They want to be paid immediately, you will be reimbursed in 120 days. Skype is probably the best way to solve the in-office interpretation problem.

  • Doug Sheets MD

    I support this resolution. The requirement for interpreter services can be a significant burden for smaller and rural practices.

  • Elizabeth H. Holt, MD, FACE

    I support this resolution. I would like to point out that some interpreters charge from when they leave their home/workplace until they return to their home/workplace so that reimbursement to the physician should include all of the time billed by the interpreter (or the interpreter should be limited to billing for only the time spent on-site).

  • Dale fell

    Strongly support this resolution and all of its components. Cost shifting to physicians by failure to pay for indicated interpretor services is not appropriate.

    It should be reimbursed.

    Also agree with need for certification.