Spanish-language and multilingual marketing for medical practices: language access, translation and ads

Many practices serve patients who prefer a language other than English, and many want to reach more of them. Spanish is the most common case in the United States, but the same questions come up for Vietnamese, Chinese, Arabic, Korean, Haitian Creole and other languages. A Spanish page, a Spanish ad or a bilingual front desk can make a real difference to whether someone books.

Marketing in another language is not only a translation job. Federal civil rights rules may apply to how you communicate with patients once they arrive, the FTC has a specific policy on disclosures in non-English ads, and search engines and Google Ads handle languages in their own ways. This guide walks through each, in plain words. Who sees an ad, by age, sex, race or language, is covered in our guide to healthcare ad targeting rules.

First question: does Section 1557 apply to your practice?

Section 1557 of the Affordable Care Act prohibits discrimination on the basis of race, color, national origin, sex, age and disability in certain health programs and activities. Its rule, 45 CFR Part 92, applies under 92.2 to every health program or activity any part of which receives federal financial assistance from HHS, to programs HHS administers, and to entities set up under title I of the ACA.

The rule treats language as part of national origin: the nondiscrimination policy and notice required by 92.8(b) and 92.10 refer to national origin “including limited English proficiency and primary language.” Whether your practice is a covered entity depends on the federal funds it receives. That is a legal question with real consequences, so put it to a health care attorney rather than guessing.

On current status: in a notice published June 2, 2026 (91 FR 32887), HHS reported that a federal court had vacated certain provisions of the 2024 Section 1557 rule to the extent they expand the definition of sex discrimination to include gender identity. The notice states that the other provisions of the rule remain in force. The language access provisions discussed here are among those other provisions.

What the language access rules require of covered practices

If Section 1557 applies, the rule sets out obligations that touch marketing directly, because your website and intake are part of your health program.

• Under 92.201(a), a covered entity must take reasonable steps to provide meaningful access to each individual with limited English proficiency eligible to be served or likely to be directly affected by its health programs and activities.
• Under 92.201(b), language assistance services must be free of charge, accurate and timely, and protect the privacy and independent decision-making of the individual.
• Under 92.201(c), interpretation must come from a qualified interpreter and translation from a qualified translator.
• Under 92.201(e), a covered entity must not require patients to bring or pay for their own interpreter, and must not rely on a minor child to interpret except as a temporary measure in an emergency.
• Under 92.8(d), a covered entity must have written language access procedures, including how staff identify limited English proficiency and how they get qualified interpreters and translators.

Two notices also involve your website. Under 92.10, the notice of nondiscrimination goes in a conspicuous location on the website, among other places. Under 92.11, a notice of availability of language assistance services goes on the website as well, and must be provided in English and at least the 15 languages most commonly spoken by individuals with limited English proficiency in the relevant state or states. Under 92.1(b), covered entities had to comply with 92.10 within 120 days of July 5, 2024 and with 92.11 within one year of that date.

What each notice must say, where it goes on the website and in which forms, and what the 2026 court notification changed are covered in our guide to Section 1557 website notices.

Machine translation: where the rule draws a line

Automatic translation is tempting for a website: one plugin and every page has a Spanish version. The Section 1557 rule addresses this directly. Under 92.201(c)(3), if a covered entity uses machine translation when the underlying text is critical to the rights, benefits or meaningful access of an individual with limited English proficiency, when accuracy is essential, or when the source materials contain complex, non-literal or technical language, a qualified human translator must review the translation.

Even for practices outside Section 1557, the same reasoning holds as a quality standard. Health content is full of technical terms, and a wrong word in instructions or a cost page can mislead a patient. A practical split:

• Have a qualified human translator write or review service pages, forms, financial policies, consent language and anything about cost or care instructions.
• Machine translation may be acceptable as a first draft for low-stakes content such as directions or office hours, but have a fluent reviewer check it before it goes live.
• Do not publish a translated page your team cannot answer questions about. If the page is in Spanish, the phone line and the intake process should be able to continue in Spanish.

Ads in Spanish: disclosures go in the same language

The FTC has a short policy statement on this, 16 CFR 14.9. Where an FTC order, rule or guide requires a clear and conspicuous disclosure, and the ad appears in a non-English publication, the disclosure must appear in the predominant language of that publication. For any other ad, the disclosure must appear in the language of the target audience, ordinarily the language principally used in the ad.

In practice that means a Spanish ad with an English-only fine print line does not do the job. If an offer has conditions, a price has exclusions, or an endorsement needs a disclosure, write those in Spanish too. The same review you give an English ad applies; our guide to healthcare marketing rules covers what that review looks for.

Google Ads in more than one language

Google changed how language works in Search campaigns. According to the Google Ads help page on language targeting, starting in September 2026 the campaign-level language targeting setting is removed for Search campaigns, and Search ads automatically match based on the language of the ads. For the Search Network portion of Performance Max, the campaign language setting no longer applies; it still applies to other Performance Max channels such as YouTube, Display, Discover and Gmail.

Google also says it uses search term language, the user’s language settings and preferences to judge which languages a person understands, and that a person who understands both English and Spanish may see ads in either. Two practical points follow:

1. Write separate Spanish ads. Since matching follows the language of the ad, Spanish ad copy is what lets the system serve Spanish ads to Spanish searches.
2. Send Spanish ads to Spanish pages. The help page describes Google checking whether a user understands the language of the creative and the landing page. An ad in Spanish that lands on an English page is a poor experience and works against that check.

When we run Google Ads for practices in two languages, each language has its own ads and its own landing pages, written or reviewed by a fluent speaker.

Building a multilingual practice website

Google Search Central’s guide to multilingual sites gives clear, practical rules:

• Google uses the visible content of a page to determine its language, not code-level language information such as lang attributes or the URL. Keep each page in a single language for content and navigation, and avoid side-by-side translations.
• Use language-specific URLs, for example a separate path for the Spanish version, rather than one URL that changes language.
• Do not automatically redirect people to a language version based on a guess about their language. Add links so people can choose the other language themselves.
• Tell Google about the language versions with hreflang annotations. Under Google’s localized versions guidance, each language version must list itself as well as all the other language versions, with fully qualified URLs.

Accessibility standards add one more requirement. WCAG 2.2 Success Criterion 3.1.1 requires that the default human language of each page can be programmatically determined, and 3.1.2 requires the same for passages in a different language. That is the lang attribute: Google says it does not use it to detect language, but screen readers use it to load the right pronunciation rules. Our guide to website accessibility for medical practices covers the wider standard.

Start small if you need to. A Spanish home page, Spanish pages for your main services, a Spanish contact and booking page, and your notices is a sound first set. A full mirror of every blog post is rarely the best first use of translation budget.

The phone call and the visit are part of the marketing

A Spanish ad that leads to a phone line nobody can answer in Spanish wastes the ad and frustrates the caller. Before launching, decide how calls and messages in each language are handled: bilingual staff who have shown they are proficient, an interpreter line, or a phone assistant that can answer common questions in Spanish and hand off to a person. Our new patient phone script guide and our AI front desk page cover the call side.

If Section 1557 applies to you, the rule is specific about who may interpret. Under 92.4, qualified bilingual or multilingual staff are workforce members designated to provide in-language oral assistance who have demonstrated proficiency in both languages, including the specialized vocabulary, and can communicate effectively, accurately and impartially. A staff member who speaks some Spanish is not automatically qualified.

Reviews, listings and content in other languages

Patients may leave reviews in Spanish. Reply in the language of the review where you can, and keep the same privacy discipline you use in English: never confirm that the reviewer is a patient or mention their care. Our guide to replying to patient reviews covers the rules. For content, write for the questions Spanish-speaking patients in your area actually ask, not a word-for-word copy of the English article.

A short checklist

• Ask a health care attorney whether Section 1557 applies to your practice.
• If it applies, check your notice of nondiscrimination, notice of availability, written language access procedures and interpreter arrangements.
• Use qualified human translation for service pages, forms, cost and care information.
• Put required ad disclosures in the same language as the ad.
• Write separate ads per language and send each to a page in that language.
• Give each language version its own URL, hreflang annotations and a correct lang attribute; let people switch languages with a link, not a redirect.
• Make sure calls, messages and intake can continue in the language the patient used to find you.

How we approach multilingual practice sites

When we build a medical practice website with more than one language, each language gets its own pages and URLs, the language settings are set correctly for search engines and screen readers, and translated text is written or reviewed by a fluent speaker before launch. We do not publish raw machine translation for service, cost or care pages.

Sources

• 45 CFR Part 92: Nondiscrimination in health programs and activities (Section 1557)
• 45 CFR 92.201: Meaningful access for individuals with limited English proficiency
• 45 CFR 92.11: Notice of availability of language assistance services and auxiliary aids and services
• 45 CFR 92.10: Notice of nondiscrimination
• 45 CFR 92.8: Policies and procedures
• HHS: Notice of Vacatur Regarding Certain Provisions of the 2024 Nondiscrimination in Health Programs and Activities Final Rule, 91 FR 32887 (June 2, 2026)
• 16 CFR 14.9: Clear and conspicuous disclosures in foreign language advertising and sales materials
• Google Ads Help: About language targeting
• Google Search Central: Managing multi-regional and multilingual sites
• Google Search Central: Localized versions of your pages
• W3C: Understanding WCAG 2.2 Success Criterion 3.1.1 Language of Page
• W3C: Understanding WCAG 2.2 Success Criterion 3.1.2 Language of Parts

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