Medical interpreters sit in exam rooms, surgical consults and emergency departments during some of a patient’s most private moments. Despite that access, most states do not license medical interpreters the way they license nurses or pharmacists. What exists instead is a patchwork of national certification exams, two state run certification programs, hospital credentialing rules, and federal privacy and anti fraud screening that applies to anyone who touches protected health information or bills a federal health program. This post walks through what is actually required, what is simply common hospital practice, and where the record shows no state rule at all.
Is there a state license for medical interpreters?
In most states, no. Medical interpreting is generally an unlicensed occupation. The structure that exists instead is national certification. Two organizations run the recognized certification exams for healthcare interpreters in the United States: the Certification Commission for Healthcare Interpreters (CCHI) and the National Board of Certification for Medical Interpreters (NBCMI). Both require passing a written and oral exam and documented training hours, and both publish codes of ethics that candidates agree to follow. Neither certifying body is a state government agency, and certification through either one is a credentialing step, not a state license.
Washington and Oregon run their own certification programs
Two states stand out because a state agency, not a private certifying body, runs its own medical interpreter credentialing program.
Washington’s Department of Social and Health Services operates a Language Testing and Certification program that issues medical interpreter credentials to people who pass its language proficiency testing and agree to the program’s code of professional conduct, as described on the DSHS page on becoming a certified interpreter or document translator. That same DSHS program points certified and contracted interpreters serving DSHS clients to the agency’s statewide screening process, run by its Background Check Central Unit, which processes criminal history checks for people working in DSHS programs that serve vulnerable populations, including fingerprint based checks and a published list of disqualifying convictions.
Oregon’s Health Authority runs a separate Health Care Interpreter (HCI) certification and registration program. The program’s own certification page, reviewed directly, describes a sixty hour training requirement and a language proficiency exam, but it does not publish a criminal history check or fingerprint requirement as part of state certification itself, based on the current content of the Oregon HCI certification requirements page. Where Oregon’s program is silent on criminal history, employers and agencies that place HCI registered interpreters generally run their own screening rather than relying on the state credential to cover it.
| Program | Who runs it | What it tests | Criminal history built into the credential |
|---|---|---|---|
| Washington DSHS Language Testing and Certification | State agency (DSHS) | Language proficiency, ethics | Contracted and certified interpreters serving DSHS clients are directed to DSHS’s own background check unit |
| Oregon Health Care Interpreter Program | State agency (Oregon Health Authority) | Sixty hours of training, language proficiency exam | Not published as part of state certification; varies by employer |
| CCHI and NBCMI national certification | Private, nonprofit certifying bodies | Written and oral exam, ethics | No criminal history component; a credentialing exam, not a background screen |
Outside these two state programs, most states have no interpreter specific licensing or fingerprint rule at all, and it is more accurate to say so than to assume one exists because a hospital or agency happens to run its own check.
HIPAA workforce rules apply the moment an interpreter can access protected health information
A medical interpreter who reads a chart, sits in on a telehealth visit, or handles written translations of medical records is generally treated as a member of a covered entity’s workforce for HIPAA purposes, whether employed directly or placed through a staffing or interpreting agency under a business associate arrangement. The HIPAA Security Rule’s workforce security standard requires covered entities to implement a workforce clearance procedure to determine that a workforce member’s access to electronic protected health information is appropriate, and to have a process for terminating that access when the engagement ends. HIPAA itself does not list a specific criminal background check as a required clearance step; it leaves the clearance method to the covered entity’s own risk analysis, which is why a hospital’s vendor credentialing office, not HIPAA directly, usually sets the actual screening standard for interpreters.
OIG exclusion screening and federal program integrity
Any healthcare provider, interpreting agency, or hospital that bills Medicare, Medicaid, or another federal health program has a separate reason to screen interpreters working in clinical settings: federal exclusion checks. The Department of Health and Human Services Office of Inspector General maintains the List of Excluded Individuals and Entities (LEIE), and employing or contracting with an excluded individual can expose a provider to civil monetary penalties even if the excluded person is not billing directly. Hospitals and larger interpreting agencies typically check staff and contract interpreters against the LEIE, and against the General Services Administration’s System for Award Management exclusion records, before placement and on a recurring basis afterward.
Section 1557 and the duty to use qualified interpreters
Separate from employment screening, federal civil rights law shapes how a hospital is supposed to use interpreters with patients. Section 1557 of the Affordable Care Act and its implementing regulation require covered health programs to take reasonable steps to provide meaningful access for patients with limited English proficiency, and the regulation specifically addresses the use of qualified interpreters when language assistance services are required. That rule is about interpreter qualification and patient access to care, not about an interpreter’s own personal background check, but it is a major reason hospitals build competency and credential verification into interpreter vendor contracts.
What hospitals and agencies commonly screen before placement
Because no single federal or state rule covers every piece of medical interpreter screening, the practical checklist comes from a mix of hospital credentialing policy and agency due diligence. Commonly screened items include a county and statewide criminal history search, a check of healthcare specific exclusion and debarment lists such as the LEIE, verification of any CCHI or NBCMI certification or a state credential where one exists, and in some cases a sex offender registry search. A motor vehicle record check generally only applies if the interpreter drives between facilities or operates an agency vehicle as part of the role, and a drug test is common in hospital settings that drug test all clinical area staff and contractors, though neither is a universal requirement across every employer.
FCRA duties when an agency hires through a background check
When a hospital or interpreting agency uses a third party consumer reporting agency to run a background check on an interpreter, candidate, or contractor, the Fair Credit Reporting Act’s employment screening rules apply. The Federal Trade Commission’s guidance on using consumer reports for employment purposes lays out the core sequence employers must follow: a clear standalone disclosure, the candidate’s written authorization, a pre-adverse action notice with a copy of the report and the Summary of Rights if the employer is considering a decision based on the report, and a final adverse action notice if that decision stands, as described in the FTC’s guidance for employers using consumer reports. A background check does not automatically show every criminal record in every state, and how far back a record can be reported varies by state law, so agencies should treat FCRA compliance as a process requirement rather than a promise about what any one report will contain.
Frequently asked questions
Do medical interpreters need a state license?
Generally no. Most states do not license medical interpreters. Washington and Oregon run their own state agency certification programs, and national certification through CCHI or NBCMI is available but is not a government license.
Does a medical interpreter certification include a criminal background check?
It depends on the program. Washington’s DSHS directs certified and contracted interpreters serving its clients to the agency’s own background check process. Oregon’s Health Care Interpreter certification page does not publish a criminal history requirement, and CCHI and NBCMI national certification exams do not include one either.
Does HIPAA require a background check for interpreters?
HIPAA requires covered entities to have a workforce clearance procedure to determine that a workforce member’s access to patient information is appropriate, but it does not specify that the clearance method must be a criminal background check. Hospitals and agencies generally decide the specific screening steps themselves.
Why would a hospital check an interpreter against the OIG exclusion list?
Providers that bill federal health programs can face penalties for employing or contracting with someone on the HHS OIG exclusion list, so hospitals and agencies commonly run that check before placing an interpreter in a clinical setting and periodically afterward.
What does FCRA require when an agency background checks an interpreter?
The agency must give the candidate a standalone disclosure, get written authorization, and if it may take an adverse action based on the report, send a pre-adverse action notice with a copy of the report and the Summary of Rights before a final adverse action notice.
Do interpreters who drive between facilities need a driving record check?
Only if driving is part of the role. A motor vehicle record check is common for interpreters who travel between sites or use an agency vehicle, but it is not a general requirement for interpreters who work on site or by phone or video.
Related reading: court interpreter background check requirements and what HIPAA actually requires for background checks.
Hospitals, clinics, and language services agencies that need consistent, FCRA compliant screening for interpreters and other contract clinical staff can learn more at Reveal Background.
This article is general information, not legal or medical advice. Screening requirements vary by state, employer policy, and the specific role, so confirm current rules with the relevant state agency or legal counsel before making hiring decisions.
