Minnesota Health Care Programs (MHCP) covers the following access services:
MHCP covers nonemergency medical transportation and other related travel expenses when the services are necessary to enable a member to obtain a covered health service from a participating provider. MHCP covers transportation to nonparticipating providers if all of the following are met:
MA covers the cost of the most appropriate and cost-effective forms of transportation. Funded completely by state and federal funds, local county and tribal agencies administer this program and reimburse the member or the provider directly for costs incurred. Examples of services and expenses for which reimbursement is, or may be, available include:
Local county and tribal agencies must inform recipients of their transportation and ancillary service benefits and reimbursements. The local agencies must help recipients find necessary appropriate level of transportation to obtain an MHCP covered health service. Each local agency has a plan detailing how it will assure that a member obtains necessary transportation and ancillary services. Local county and tribal agencies may require authorization for the transportation and ancillary services they provide or reimburse.
Refer to the following for more information:
Neither the nonemergency medical transportation (NEMT) nor the related ancillary service charges are applied to an existing spenddown obligation of a member. Members with a spenddown obligation remain eligible for NEMT and related ancillary services to get them to and from their medical appointments. MHCP will reimburse for transports and ancillary services to the local agencies or enrolled NEMT provider.
All providers are required to provide language interpreter services as follows:
MHCP covers sign and spoken language interpreter service with the following conditions if the provider cannot communicate effectively with the member:
MHCP also covers language interpreter services for the parent or guardian when the patient is a minor.
In some cases, providers need to make interpreter services available on an expedited or emergency basis.
Translating documents (paper to paper) is not a covered spoken language interpreter service.
All language interpreters must be qualified and competent, as well as the following:
MHCP does not enroll interpreters as providers.
All MHCP-enrolled providers except those listed below may bill MHCP for sign and spoken language interpreter services if the provider cannot effectively communicate with the recipient.
Ineligible for interpreter services
MHCP will not reimburse the following provider types for interpreter services:
MCO providers: contact the patient’s MCO for network sign and spoken language interpreters and billing instructions.
MHCP covers sign and spoken language interpreter services when such services are necessary to help deaf or hard of hearing members or members with LEP get covered services, and the members are eligible for one of the following programs:
Alternative Care Program
MHCP does not cover sign and spoken language interpreter services when recipients are eligible for one of the following programs:
Institution for Mental Disease
DHS Deaf and Hard of Hearing Services (DHHS) regional staff located throughout Minnesota can help with questions about sign language interpreter referral services or hiring freelance sign language interpreters. Refer to the DHHS and Sign Language Interpreter Referral websites for more information and resources or call 651-431-3253 or TTY 888-206-6507.
MHCP covers spoken language interpreter services only when the interpreters are actively enrolled in the MDH Spoken Language Interpreter Roster. Providers, including those enrolled with MCOs, are responsible to verify that spoken language interpreters are enrolled in the roster.
In August 2003, the U.S. Department of Health and Human Services published its own Guidance to Federal Financial Assistance Recipients Regarding Title VI Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons, designed to help providers understand the extent of their obligation to provide interpretation and translation services to patients with LEP.
Take reasonable steps to provide effective spoken language interpreter services when such services are needed to help a person with LEP get medical services.
To know what reasonable steps to take, start by conducting an individualized assessment that balances four factors:
The results of this four-factor analysis helps you determine the mix of language assistance services you should provide. For example, in most cases, interpreter services will be the most effective type of language assistance available. However, other forms of language assistance may be appropriate, such as using translated application forms and other documents, or using bilingual staff members who are proficient in both English and a non-English language. Base language assistance services on what provides meaningful access and is reasonable and necessary given the results of the four-factor analysis (Guidance pages 47314-16).
DHS strongly encourages you to develop a written LEP plan, policy and procedure that describes how you will offer free and timely interpreter or other language assistance services to effectively communicate with non- or limited-English speaking patients. An LEP plan does not have to be lengthy or complicated. It may be as simple as being prepared to use a commercial telephone interpreter service or identifying bilingual staff members within the office who are proficient enough in both English and a non-English language to effectively communicate with a patient in his or her primary language (Guidance pages 47319-20).
Refer to the LEP plans web page and to the Limited English Proficiency Plan (DHS-4210) (PDF) for more information or a template for your LEP plan.
You are not required to develop a written LEP plan if you serve very few people with LEP or have very limited resources. However, you are responsible for providing meaningful access to services for your patients with LEP and must have a plan, written or not, to do so. Consider alternative reasonable ways to show how you provide meaningful access in compliance with Title VI. Should a complaint arise, you must be able to show intent to comply with the law and have documentation sufficient to show what happened in the particular case.
Do not plan to rely on a person’s family members, friends or other informal interpreters to provide meaningful access to services. Respect a person’s desire to use an interpreter of his or her own choosing in place of the language service you may offer. You may use a patient’s family member or friend as an interpreter in emergencies (Guidance pages 47317-18).
Qualified spoken language interpreters must understand and follow confidentiality and impartiality rules to the same extent as the staff person involved (Guidance page 47316). Under the Guidance, an interpreter must be competent to provide interpreter services. Competency does not require formal certification as an interpreter, but does require more than just self-identification as bilingual.
Submit an authorization request for additional interpreter service units only after the allowed 8 units (1 unit = 15 minutes) of interpreter services per date of service have been used. The prior authorization must include, but is not limited to:
Do not include the initial 8 units as part of the additional interpreter units being requested.
Submit the authorization request to KEPRO through the MHCP authorization process.
Providers are responsible for providing interpreter services, at the provider’s expense, for patients whose coverage does not cover interpreter services. The amount paid by MHCP may not cover the full cost of the interpreter service. Providers must bear the cost or cost-difference for providing interpreter services. For interpreter services, providers must document the following in the patient’s chart:
For MCO enrollees, contact the recipient’s health plan for billing instructions.
Bill sign or spoken language interpreter services to MHCP using the following guidelines:
Face-to-face spoken language interpreter service
Face-to-face sign language interpreter service
Telemedicine interpreter service via interactive audio and video telecommunications systems
Interpreter service provided via telephone, smartphone, tablet or other similar processes. Does not include delivery of telemedicine interpreter service
Interpreter service provided in a group setting:
MHCP does not cover these interpreter expenses:
Interactive audio and video telecommunications: Interpreter services provided to a patient when the medical service provider and patient are at the originating location and the interpreter is at another location. Interpreter services are delivered using telephone and other forms of interactive audio and video communications equipment.
Interpretation: The oral replacement of one spoken language (source language) into another spoken language (target language). Four modes of interpretation exist: consecutive, simultaneous, summarization and sight translation (when the interpreter reads text in one language and speaks it in another language). Includes sign language services.
Telemedicine: The delivery of health care services or consultations while the patient is at an originating site and the licensed health care provider is at a distant site. See the “Physician Services” section for additional information for telemedicine service.
Translation: The written replacement of text from one language (source language) into an equivalent text in another language (target language).
Person with LEP: A person not able to speak, read, write, or understand English at a level that allows him or her to interact effectively.
The Exchange Translations and Resources for Better Health is a Minnesota-based collaboration of health organizations to exchange information and resources about health communication and to share multilingual health materials. It is a resource for providers about language and cultural competency.
Minnesota Statutes 256B.0625, subd. 18a(d) Covered Services, Access to medical services
Minnesota Rules 9505.0140 Payment for Access to Medically Necessary Services, Access to medically necessary services
Minnesota Rules 9505.2175 Health Service Records, Language interpreter services