Health Care Reform – 2012 List of Counties Requiring Culturally and Linguistically Appropriate Services Issued by HHS

April 10, 2012

This is the tenth in a series of advisories on Health Care Reform and other recent developments in health care. This advisory summarizes the most recent guidance released by the Department of Health and Human Services (HHS) listing the counties where certain notices are subject to the additional requirement that they be provided in a “culturally and linguistically appropriate manner.” The counties include ones in New York, New Jersey, North Carolina, Georgia, Virginia and a number of other states and Puerto Rico where more than 10% of the population is literate only in Spanish.

Two provisions of the Patient Protection and Affordable Care Act (PPACA) require that relevant notices to be provided in a “culturally and linguistically appropriate manner” – (1) the enhanced internal claims and appeals requirements and external review procedures ; and (2) the summary of benefits and coverage. In order to satisfy this requirement, certain accommodations are necessary where notices are sent to an address in a county where 10% or more of the population is literate only in the same non-English language:

English versions of notices must include a statement prominently displayed in any applicable non-English language clearly indicating how to access the language services provided by the plan or issuer.
Upon request, notices must be provided in any applicable non-English language.
Oral language services (such as a telephone customer assistance hotline) that include answering questions in any applicable non-English language and providing assistance with filing claims and appeals (including external review) in any applicable non-English language.

The 10% threshold is based on U.S. Census data and is updated annually. The Department of Health and Human Services has issued the list for 2012 of the counties where 10% or more of the population is literate only in the same non-English language. The 2012 list can be found at the following website:

http://www.cciio.cms.gov/resources/factsheets/clas-data.html

Employers with employees in the counties listed first need to arrange for translation services for the statement to be placed on the English version of the various notices and for the notices themselves, if requested. In addition, arrangements will need to be made to provide the oral, non-English language service to assist with questions and the filing of claims.

Note that these advisories on health care reform are subject to the constitutionality of PPACA, which is currently under review by the United States Supreme Court.