Section 1557: Who is covered/needs to comply?

Find complete information on, including 1557 FAQs and The Basics on What You Must Do.

Dentists and dental practices that receive federal funding must comply with Section 1557:

  • Dentists and dental practices that receive certain payment from HHS, such as Medicaid or CHIP reimbursement or “meaningful use” payments under the Medicare and Medicaid Electronic Health Records Incentive Program must comply with the Section 1557 final rule. 
  • The Section 1557 final rule does not apply to dentists or dental practices who only accept reimbursement under Medicare Part B.
    • HHS has taken the position that a dentist (or dental practice) that receives reimbursement from a Medicare Advantage plan is covered by the final rule, whether the plan pays the dentist or the patient.

Missouri Specific Taglines

In accordance with Section 1557 rules, covered dental practices are required to post two notices: (1) a Notice of Nondiscrimination and (2) Taglines. These notices must be posted by October 16, 2016.

As a member value, the ADA has developed a sample Tagline and is providing it in the top 15 languages for states and US territories to all our members. More information, including links to sample Notices of Nondiscrimination, are available in the ADA Notice and Taglines Requirements FAQ

Click for Missouri Specific Taglines PDF

To learn more about Section 1557 and for FAQs, visit Read more in ADA News.

ADA Endorsed CyraCom for Interpretation and Translation Services

CyraCom provides phone and video interpretation, enabling dentists to communicate with their non-English-speaking patients in seconds. CyraCom services are fully compliant with Section 1557 of the Affordable Care Act. ADA members pay only $.81/minute (compared to the regular price of $2.49/minute; a nearly 70% savings off of interpretation services). There's also no minimums and no set-up fees! Learn more.

Translation Services

Some members have inquired about where to have health history and privacy forms translated to serve their non-English speaking patients. The MDA does not endorse any particular company, but is aware of International Language Center, which has translated brochures for MDA in the past. The company headquarters is in St. Louis. Learn more about their translation services.

It is the understanding of the MDA that the two companies referenced on this page for interpretation services (Cyracom and All Access Interpreters) provide interpretation services only and not translation services. 

Translation/Interpretation Services for Section 1557: Missouri Specifics 

The following is specific to Missouri and is an update to a provision of ACA Section 1557 which states “Covered* dental practices will be required to take reasonable steps to provide meaningful access to individuals with limited English proficiency (LEP) who are eligible to be served or likely to be encountered, and to take appropriate steps to ensure that communications with individuals with disabilities are as effective as communications with others."

The MDA has inquired with Dr. Joe Parks, MO HealthNet Director, on providing translation coverage through the Medicaid program.

In our letter to Dr. Parks, dated September 8, 2016 the MDA commented about the calls we were receiving from our members related to the requirements of Section 1557 of the Affordable Care Act. We outlined that in this section it requires providers who are enrolled in Medicare and/or Medicaid to provide a translator for patients whose first language falls within the top 15 languages found in the state.

It also requires a posted notice of nondiscrimination and taglines that alert individuals with limited English proficiency the availability of language assistance services. However, one of the greatest concerns is the requirement for translator services. Specifically we outlined one dental office that indicated they see Bosnian/Serbian/Croatian Medicaid patients. In the call, the dental office outlined why their office would likely no longer be able to accept Medicaid. The thoughts of the provider were:​

“The great cost associated with these translator services will be absorbed by small practices like mine, and those practices also will bear the brunt of the liability should there be a misinterpretation by the translator regarding the patient’s diagnosis and/or treatment plan. To expect small practices to provide these costly services will likely mean the decline of Medicaid providers, which will ultimately lead to MORE of a need for dental care and services rather than less, as I am sure was the intention behind this over-reaching piece of legislation.”

MDA asked that for the continuity and quality of care for patients, as well as the ability for Medicaid providers to continue providing services to those recipients, that MO HealthNet find a way to reimburse providers for the costs they will undoubtedly incur due to this requirement.

MO HealthNet responded with some information about services that are covered under the current managed care (MCO) contracts. They are researching how they can provide translation services for the fee-for-service side of Medicaid in Missouri.

The services that are required under the contract with the MCOs states: The health plan shall make interpreter services available as necessary to ensure that members are able to communicate with the health plan and providers and receive covered benefits. The health plan shall use certified interpreters. The health plan shall inform members of the availability of interpreter services, how to access them, and that there is no charge for the services.

How the Interpreter/translation Service works: It is our understanding that interpreter services will bill the MCOs directly. This takes the burden of billing off of the individual provider. This only works for the Managed Care patients.

As for NON managed care patients (fee-for-service), again, MO HealthNet is exploring how they can provide translation/interpretation services for those patients. The providers will be updated on what transpires as soon as we are made aware. There likely will be a MO HealthNet bulletin sent to all dental providers with regards to these services. For now, one company the MDA is aware of that can provide interpretation services remotely (which is allowable in the 1557 rules) is:

All Access Interpreters
Nikki Lopresti

They define interpretation services as oral communication and translation services as written communication. MO HealthNet has made MDA aware of this company, as they are an authorized Vendor of the State. The company has indicated that most offices that have an electronic dental record and a video camera can use their service. The installation of the software is coordinated with the IT Department at All Access Interpreters. This installation can be done remotely and only takes a few minutes. The configuration of the software is only done once, after which, interpreters can be accessed. See rate structure below. (This company does provide onsite services in the St. Louis area only at a cost of $45/hour). The company, when seeing an MCO patient, would bill the MCOs directly for managed care patients. If they don’t have an EDR, then other arrangements will need to be made, but it is pretty simple. As for the fee-for-service patients, the company also can provide the service and would bill the provider directly for that service at least for now until MO HealthNet determines if they can cover and outlines how that reimbursement would work.

Rates For Video Interpreting

Language Rate/minute  Minimums 
Spanish  $1.25/min  None 
All other languages  $1.75/min  15 minutes 
American Sign Language  $2.50/min  30 minutes 

In either case, the provider is responsible for making sure the service is available. In one case (MCOs) it is a paid service, in the other case (fee for service), right now, it is not.

Providers must remember that when you are working with a company for these services, you will need a business associate agreement to comply with HIPAA. The ADA has sample contracts that can be used (see No. 6 Auxiliary Aids and Services FAQ) and multiple other resources on this topic at