Nebraska May Soon Reimburse Translation and Interpretation for Patients on Medicaid

Nebraska May Soon Reimburse Translation and Interpretation for Patients on Medicaid

Nebraska’s Health and Human Services Committee is now considering a bill that would reimburse healthcare providers for offering their patients language services — namely, translation and interpreting. 

More specifically, the bill (LB62) applies to healthcare providers treating patients with limited English proficiency (LEP) who participate in the state’s Medicaid program. 

The nondiscrimination provision of the Affordable Care Act (ACA, or Obamacare), known as ACA 1557, mandates that healthcare providers receiving Federal funds enable language access for LEP patients — including healthcare providers who accept Medicaid.

According to coverage by the Lincoln Journal Star, reimbursements for interpreter services suddenly stopped in early 2023. However, as early as 2017, HHS had informed healthcare providers in the Nebraska Medicaid network that Medicaid was not responsible for reimbursements for language services. 

The combined ACA mandate, in addition to strict standards from the Joint Commission, the certifying body for hospitals, meant providers were forced to pay for translation and interpreting services out of their own budgets. 

Costs and Calculations

Omaha Senator Machaela Cavanaugh initially introduced LB62 in January 2023 and has pressed for the bill to be considered again in 2024. A number of amendments have been incorporated and as of March 7, 2024, the next move lies with the Nebraska Health and Human Services Committee.

According to a March 1, 2024 statement by the committee, reimbursement would begin January 1, 2024, so it is unclear whether the start date will be adjusted or the reimbursements will apply retroactively. 

Estimates of the cost of this bill vary from USD 3.87m to 4.89m for FY 2024-25. The figures depend not only on the reimbursement rate, which is different for children versus adults, but also on the number of Nebraskans estimated to have LEP (4.75% of the state’s population, which translates to nearly 16,400 Medicaid enrollees) or to be Deaf (1% of the population, or about 3,400 Medicaid enrollees).  

The fiscal note accompanying the bill cites a 2018 article to estimate the average cost per claim (USD 50). It also includes a breakdown by HHS of the services needed: 10%, in-person interpretation at USD 195 per visit; 65%, over-the-phone interpretation (OPI) at USD 22.50 per 15-minute visit; and 25%, video remote interpretation (VRI) at USD 40.80 per 15-minute visit.  

So far, 20 Nebraskans — representing either themselves or organizations — have posted comments in support of the bill; just two have been against it. The Department of Health and Human Services has so far contributed a “neutral” comment.