Dear State Medicaid Director Letter Regarding Medicaid/SCHIP Reimbursement for

Executive Summary

Letter from the Centers for Medicare & Medicaid Services detailing how states can use Medicaid and CHIP funding to pay for language services for limited English proficient (LEP) enrollees.

Dear State Medicaid Director: 
Over the past few years, States have made considerable progress in increasing access to health care coverage for lowincome families through Medicaid and the State Children's Health Insurance Program (SCHIP). Problems persist, however, for individuals with limited English proficiency (LEP) in enrolling and accessing services because of their inability to communicate effectively with program staff and providers. 
The Office of Civil Rights (OCR) of the U.S. Department of Health and Human Services (HHS) has issued "Policy Guidance on the Title VI Prohibition against National Origin Discrimination As It Affects Persons with Limited English Proficiency", which discusses the responsibilities under Title VI of health and human services agencies and providers who receive Federal financial assistance from HHS. All entities which receive Federal Medicaid and/or SCHIP funds — including State Medicaid agencies and State agencies or contractors administering SCHIP, as well as providers of Medicaid and SCHIP services — are covered by the guidance. 
A copy of the guidance is enclosed for your review. While we encourage you to contact OCR about the details of the guidance, we would like to emphasize that under both the SCHIP and Medicaid programs, Federal matching funds are available for States' expenditures related to the provision of oral and written translation administrative activities and services provided for SCHIP or Medicaid recipients. Federal financial participation is available in State expenditures for such activities or services whether provided by staff interpreters, contract interpreters, or through a telephone service. 
A copy of this guidance has also been sent to your Governor and will be published as a notice in the Federal Register. If you have any questions or suggestions regarding this guidance, please contact the Office of Civil Rights or your HCFA regional office. 
Timothy M. Westmoreland 


All HCFA Regional Administrators 
All HCFA Associate Regional Administrators for Medicaid and State Operations 
Lee Partridge – Director, Health Policy Unit, American Public Human Services Association 
Joy Wilson – Director, Health Committee, National Conference of State Legislatures 
Matt Salo –  Director of Health Legislation National Governors' Association

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