HHS Issues 2012 List of Counties Requiring Culturally and Linguistically Appropriate Services | Practical Law

HHS Issues 2012 List of Counties Requiring Culturally and Linguistically Appropriate Services | Practical Law

The Department of Health and Human Services has issued a list of counties that will require culturally and linguistically appropriate services in 2012 under the Affordable Care Act (ACA).

HHS Issues 2012 List of Counties Requiring Culturally and Linguistically Appropriate Services

by PLC Employee Benefits & Executive Compensation
Published on 13 Mar 2012 • USA (National/Federal)
The Department of Health and Human Services has issued a list of counties that will require culturally and linguistically appropriate services in 2012 under the Affordable Care Act (ACA).
The Affordable Care Act (ACA) requires that claims and appeals notices be provided in a "culturally and linguistically appropriate manner." This requirement, set out in Section 2719 of the Public Health Service Act (PHSA), applies to:
  • Non-grandfathered group health plans.
  • Health insurers offering non-grandfathered health insurance coverage.
The regulations implementing Section 2719 of the PHSA require covered plans and insurers to make certain accommodations for relevant notices sent to an address in counties meeting a threshold percentage of people who are literate only in the same non-English language. The regulations set the threshold percentage at 10% or more of the population residing in the claimant's county. This generally means that in US counties in which at least 10% of the population is literate only in the same non-English language, plans and insurers must provide:
  • Interpretive services.
  • Written translations of the notice on request in certain non-English languages.
  • Disclosure, in the English version of the notice, of the availability of language services in the relevant non-English language.
Implementing regulations issued in June 2011 included a table of all counties that met or exceeded the 10% threshold, applicable for 2011. The Department of Health and Human Services (HHS) has issued an updated list, applicable for 2012, of all of the counties that meet or exceed the 10% threshold. The list includes:
  • The county name.
  • The state that each county is located in.
  • The percentage of individuals who speak:
    • Spanish;
    • Chinese;
    • Tagalog; and
    • Navajo.
The HHS list:
  • Is based on 2006-2010 American Community Survey (ACS) data published by the US Census Bureau.
  • Will be updated annually.

Practical Impact

The updated HHS list includes both counties that have dropped off the list since the 2011 version, and others that have been added, so plans and insurers should take note of the 2012 changes. Importantly, the "culturally and linguistically appropriate manner" rules also apply to summaries of benefits and coverage (SBCs) under the ACA
For more information on the claims and appeals requirements, see Practice Note, Internal Claims and Appeals under the ACA. For information about SBCs, see Practice Note, Summary of Benefits and Coverage under the ACA.