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APIAHF ACTION ALERT
Revised Medicaid Managed Care Regulations Issued – Support for
Cultural and Linguistic Requirements Needed
Background
On August 20, 2001, the Centers for Medicare and Medicaid Services
(CMS) published a revised Proposed Rule for Medicaid Managed Care.
There are several important changes from the January 2001 version of
these regulations, which were never allowed to go into effect by the
Bush Administration. The regulations still contain critical
requirements for States and managed care organizations to identify
and serve enrollees and potential enrollees, including persons with
limited English proficiency (LEP). The Proposed Rule also includes
requirements for the provision of written materials in prevalent
non-English languages, oral interpretation services free of charge,
and notification that these services are available and how to access
them.
While advocates for improving linguistic access in government
programs applaud the inclusion of these provisions, the revised
Proposed Rule greatly weakens the requirements for the provision of
culturally competent services by managed care organizations compared
to previous versions of the rule. CMS has asked for public comment
on the Proposed Rule. While this provides additional opportunity for
input, it also allows those opposed to the linguistic access
requirements to organize and urge the weakening or elimination of
those requirements.
APIAHF is urging all parties to send comments to CMS on these
regulations. We have attached a sample letter for you to print out
and send. Please include one original and three copies to the
address on the letter.
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SAMPLE LETTER- see attached
MS Word document, or cut and paste letter below:
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Centers for Medicare and Medicaid Services
Department of Health and Human Services
Attention: CMS-2104-P
P.O. Box 8016
Baltimore, MD 21244-8016
[DATE]
Re: CMS-2104-P. Medicaid Program; Medicaid Managed Care;
Proposed Rule.
To Whom It May Concern:
[Short description of your organization] We are writing to
provide comments regarding the Medicaid Managed Care Proposed Rule
published in the Federal Register, August 20, 2001.
First, we would like to applaud the inclusion of the information
reporting requirements in §438.10, which would reinforce existing
language requirements under Title VI of the Civil Rights Act of 1964
to prohibit discrimination on the basis of national origin. The
provision of translated written materials, oral interpretation
services, and notification of language rights helps to ensure equal
access to services for limited English speaking persons.
While we support the retention of these critical provisions for
ensuring linguistic access for all Medicaid clients, we are
disappointed in the decision to weaken provisions of §438.206
requiring managed care organizations to provide culturally competent
care. The original provision required each managed care organization
(MCO) or prepaid health plan (PHP) to "ensure that services are
provided in a culturally competent manner to all enrollees",
but the current Proposed Rule only requires health care
organizations to participate in States’ efforts to promote the
delivery of culturally competent manner. While we certainly support
any provision that would require health plans to comply with State
quality improvement efforts as stated in §438.206 of the Proposed
Rule, we recommend the restoration of the original language as
published in the January 19, 2001 Federal Register, Medicaid
Managed Care, Final Rule.
Health care consumers are becoming an increasingly diverse
population. Systems of care must be designed to be respectful of and
responsive to cultural and linguistic needs in order to provide
equal access to quality health care. Furthermore, ensuring that
services are delivered in a culturally appropriate manner
contributes to the national objectives promoted by the U.S.
Department of Health and Human Services, Initiative to Eliminate
Racial and Ethnic Disparities in Health, and the Healthy People 2010
Campaign.
We appreciate your consideration of these recommendations. Thank
you.
Sincerely
SIGNATURE
NAME/TITLE
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