Last month, the Federal government issued new regulations on the internal claims and appeals and external review processes for private group health plans and health insurers as part of the Affordable Care Act. These regulations have significantly weaker language access provisions in response to exaggerated complaints from insurers about the costs of implementing California’s landmark language access law, SB 853.

Under the revised Interim Regulations, plans will only have to provide translated consumer notices in languages that 10% of the population of a county read, while oral interpretation will be required in only those same languages. These standards are not only weaker than the initial proposal; they take a step back and undermine Title VI of the Civil Rights Act that requires oral interpretation to be provided in all languages. Please submit your comments for stronger language access standards TODAY. Comments must be received by July 25th.

Suggested comments:

• I wish to comment on the proposed 10% threshold for translation and oral interpretation of private plan materials in internal review and appeal contexts.
• The proposed standards fail to recognize the needs of the 12 million residents in the United States who do not speak English well, over half of whom reside in California.
• As health plan and insurance members, they pay premiums and receive marketing materials and calls in their primary language, but under these proposed regulations, they would not be able to access plan review and appeals materials to ensure they receive the care they need.
• The Centers for Medicaid & Medicare Services (CMS), Internal Revenue Service (IRS), and Department of Labor (DOL) should immediately revise these joint Interim Regulations. Specifically they should:
  • Require large group plans to provide notices to 5% of the plan’s population or 500 persons in a plan’s service area and 25% of the population for small group plans.
  • Provide oral interpretation in all languages at all times under Title VI of the Civil Rights Act of 1964, reiterated in Section 1557 of the ACA, and by Executive Order published at 65 Fed. Reg. 50,121-22 (Aug. 16, 2000).
  • Require the identification (“tagging and tracking”) of a member’s spoken and written language need as required by Title VI Office of Civil Rights in order to ensure effective communication about medical instructions and vital patient information critical to the provision of quality care.
  • Reject bogus claims by health plans that these regulations will be too costly by using California’s language access law, SB 853, as an example. These federal regulations apply to a much narrower set of documents – notices about appeals and denials of medical coverage – than those covered by SB 853. In addition, the costs health plans are citing are one time translation costs for documents that will be used for many years.

You can submit comments in the following ways:

1. Electronically. You may submit comments to www.regulations.gov. Enter docket ID number EBSA-2010-0019-0002 in the "Enter Keyword or ID" field and click on "Search." On the next web page, click on the "Submit a Comment" action and follow the instructions.
2. By express or overnight mail. You may send written comments to the following address: Centers for Medicare & Medicaid Services, Attention: CMS-9993-IFC2, Mail Stop C4-26-05, 7500 Security Blvd., Baltimore, MD 21244-1850.
3. If you are bilingual or work with limited English proficient populations, consider filing comments in other languages as well as in English, to demonstrate the need and importance for strong language access regulations.