When Medicare Advantage and Part D plan companies send out their notice of 2009 plan changes this fall, they are requested to note front and center what other languages the notice is available in. This is different than past years where the Center for Medicare and Medicaid Services (CMS) provided no such guidance. Even if a plan did have notices available in Spanish and/or other languages, often times they failed to disclose this information, or if they did, it wasn’t done ‘front and center’ on the first page. In such cases, beneficiaries speaking another language had no way of knowing whether translated materials were available. In CMS’ 2009 Call Letter sent out mid March, CMS’ 2009 Standardized Model Combined ANOC/EOC (Annual Notice of Change/Evidence of Coverage) explicitly states where companies should state that this information is available in another language(s) and that that statement should then be repeated directly below in the language(s) available.
While CMS is still ‘requesting’ rather than ‘requiring’ plans to follow this guidance, just having this guidance marks a victory in continuing to improve language access for beneficiaries with limited English proficiency (LEP). It will also help advocates track which plans are providing translated materials and in what languages.
CMS marketing guidelines already require plans to make all marketing materials available in any language that is the primary language of at least 10% of the population in a plan’s geographic service area. Yet, CMS surveillance as to whether plans are following through with this requirement has been little to none. Also, this 10% threshold is much looser than the 5% level required by California for some of its state programs, such as hospitals where language services and translated materials must be provided for language groups that comprise at least 5% of the facility’s geographic service area. (See California Health & Safety Code § 1259). This tighter threshold ensures that marketing and outreach of some state programs cater to many more languages than Medicare’s materials currently do.
Information/resources on language access
Listed below from a previous article are some resources and further information on Medicare’s recommended role in providing language services as well as language access activities, resources, legislation and publications.
- Paying for Language Services in Medicare: Preliminary Options and Recommendations – a report by NHeLP and the Center on Budget and Policy Priorities that discusses why and how Medicare can cover language assistance for beneficiaries.
- Do You Speak E-N-G-L-I-S-H? Medicare Part D Plans Fail Limited English Proficient Beneficiaries – an issue brief from The Greelining Institute and National Senior Citizens Law Center detailing Part D plans’ inadequate services to LEP enrollees and providing numerous recommendations for change.
- The California Endowment Language Access webpage – links to numerous publications on language access issues, such as: a tool kit for physicians for addressing language access issues; California county profiles on the Limited English Proficient (LEP) populations; and a ‘how to choose a language agency’ guide for social service providers.
- NHeLP’s Language Access Resources – a section of NHeLP’s site with a wealth of language access information including: language access activities/actions by state; compilations of research, studies, and promising practices; information on federal legislation; and publications from NHeLP, the California Endowment, and other advocacy organizations.
- NHeLP’s Language Access in Health Care Statement of Principles – a statement on the need and significance of providing language access services for providing quality health care to all people. NHeLP encourages organizations in support of these principles to sign on.