Language-access regulations can change, and health plans need practical information about what current rules require. This article focuses on written communication for Medicare beneficiaries, and requirements for translated documents and accessible formats.
Why CMS Strengthened the Requirements
Medicare Advantage organizations and Part D sponsors have long been required to translate certain materials into any non-English language that is the primary language of at least 5% of individuals in a plan benefit package service area.
However, beneficiaries sometimes had to request each translated or accessible document separately. This created delays and made it harder for people to receive important information consistently.
The growing number of people enrolled in both Medicare and Medicaid created another challenge. Some Medicaid programs required languages that did not meet Medicare’s 5% threshold.
CMS addressed these problems through requirements that took effect for materials produced for contract year 2024. Those requirements remain in effect.
What the Current Requirements Say
Under 42 C.F.R. § 422.2267 and 42 C.F.R. § 423.2267, Medicare Advantage organizations, cost plans, and Part D sponsors must:
- Translate required materials. CMS-required materials must be translated into each non-English language that is the primary language of at least 5% of individuals in a plan benefit package service area. Required materials contain information CMS considers vital to beneficiaries, including information about enrollment, benefits, health, and rights.
- Honor standing language and format needs. Once an enrollee requests materials in an applicable language or accessible format—or the plan otherwise learns of that need—the plan must provide future required materials that way on a standing basis.
- Provide accessible formats. Plans must provide required information in formats appropriate to an enrollee’s disability and communication needs. Depending on the individual, this may include Braille, large print, audio, or another accessible format.
- Apply the requirement to individualized plans of care. The standing language and accessible-format requirement also applies to individualized plans of care for special-needs-plan enrollees.
- Meet additional Medicaid standards. Fully integrated dual-eligible special-needs plans, highly integrated dual-eligible special-needs plans, and applicable integrated plans must satisfy Medicare’s translation standard and any additional language requirements in their Medicaid capitated contracts.
Covered entities subject to Section 1557 must also provide a notice explaining that free language assistance and auxiliary aids are available. Under 45 C.F.R. § 92.11, the notice must appear in English and at least the 15 most common languages spoken by people with limited English proficiency in the relevant state or states. It must also be available in appropriate accessible formats.
Steps Health Plans Should Take
Plans should build these requirements into their everyday operations:
- Identify and record member needs. Create a reliable system for documenting each enrollee’s primary language and accessible-format needs.
- Inventory required materials. Determine which CMS-required documents need translation based on service-area demographics and applicable Medicaid contracts.
- Simplify the source content. Clear English improves comprehension and makes translation faster, more consistent, and more economical.
- Plan for accessible production. Establish processes for producing Braille, large-print, audio, and accessible digital materials within required timeframes.
- Train staff. Employees should understand how to identify language and accessibility needs, record standing preferences, and route requests correctly.
- Work with an experienced language-services provider. Professional support can improve accuracy, consistency, scalability, and turnaround times. The regulated organization, however, remains responsible for compliance.
Partnering for Seamless Compliance
LanguageLine offers end-to-end consulting to assist in helping you comply with these new standards. We also have a CMS expert on staff to assist with your understanding of all regulations.
For individual steps listed above, LanguageLine offers a comprehensive suite of solutions, including translation and localization services for member handbooks, benefits information, notices, directories, formularies, appeals, grievances, and other health-plan communications.
Our alternative-format services support Braille, large print, DAISY, E-Text, audio, and other accessible deliverables. Multilingual desktop publishing helps preserve layouts, tables, branding, and readability across languages and formats.
For large volumes of recurring content, LanguageLine AI Solutions combine technology with human expertise and quality controls. Regulated or consequential member communications can be routed for professional review based on their risk and complexity.
The secure LanguageLine Translation Portal allows teams to submit projects, request quotes, monitor progress, and manage translation work from one location.
LanguageLine can help health plans build efficient translation and accessibility workflows around current CMS requirements.
We invite you to contact us today to discuss your language access needs and how we can help you seamlessly comply with CMS requirements.
