Current Legal Requirements of Language Access in Health Care Settings

Title VI of the Civil Rights Act of 1964 sets the stage for all other health care regulations regarding the LEP population, requiring that any organization (including health care organizations) must not discriminate based on race, color, or national origin.

In addition, service providers would have difficulty complying with certain laws, such as EMTALA (Emergency Medical Treatment and Active Labor Act) without being able to communicate with LEP patients. According to the National Health Law Program, “lack of knowledge and enforcement leaves millions of LEP individuals without meaningful access to health care.”1

All 50 states now have laws that address the issue of language access in health care settings. Seventeen states have language access laws addressing insurance providers and/or managed care organizations. Some are broader than others; California by far has the most comprehensive set of regulations.

Here are some highlights of state law as it pertains to language access and health care plans:

California
All California health plans must provide language assistance services to their enrollees with LEP. Under the legislation, the Department of Managed Health Care (DMHC) is charged with formulating language assistance program regulations and ensuring health plan providers’ compliance.

All vital documents must be translated into threshold languages, and interpretation services must be made available to enrollees at all points of contact. The DMHC will review health plan providers’ language assistance programs to evaluate their compliance and cultural competency.

By January 1, 2009, every plan was to have established and implemented a language assistance program. In addition, every contract between a health care provider and a plan requires compliance with the plan’s language assistance program standards.

Colorado
All managed care plans must have an access plan that includes the carrier's efforts to address the needs of covered persons with limited-English proficiency and with diverse cultural and ethnic backgrounds.

New Mexico
When marketing to State Insurance Coverage members, if there is a population of greater than 5% in the Managed Care Organization (MCO) membership that has limited-English proficiency, marketing materials shall be available in the language of that population.

Oregon
Primary Care Managers (PCMs) with the Oregon Health Plan are to have a plan to access interpreters for each substantial population of non-English speaking PCM members (35 same-language, non-English speaking households enrolled with the PCM).

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