Diverse Population-Cultural and Linguistic Needs
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Governance of annual assessment and operational actions to ensure Network Health provides culturally and linguistically appropriate clinical and non-clinical services to its members across all lines of business.
added additional information about TTY and approved via consent at the quarterly Quality Management Committee on 09/18/2025.
Annual update and additions based on CMS regulatory changes
Operational Criteria and Actions
Operational criteria and actions
Criteria and operational actions Network Health will take based on assessment findings:
ALL of the following
Required actions
- Review the languages and cultural backgrounds of practitioners in the provider network to assess whether they meet the language needs and cultural preferences of the member/participant population.
- Take action to adjust the practitioner network if the current network does not meet the cultural and linguistic preferences of the population.
- Provide translations of the Plan's required member/participant materials and make them available upon request in the identified prevalent language; basic enrollee information will also be available to the visually impaired upon request.
- Notify Medicare Marketing that translated materials must be made available to members/participants if >5% of members/participants speak a language other than English as their primary language.
- Designate practitioners who speak languages other than English in Practitioner Directories.
ALL of the following
- Make translator services available for non-English speaking members; when staff cannot provide translation, provide access to GLOBO translator services for Customer Service, Care Management, Operations, Pharmacy and Sales.
- Provide TTY/TTD 711 relay services for hearing impaired members; service is available in English and Spanish and can be initiated from any telephone in the United States.
- Ensure member/participant materials explain how to obtain language assistance initially upon enrollment and annually thereafter.
ALL of the following
- Track and review member/participant complaints and appeals regarding the Plan's ability to meet special linguistic and/or cultural preferences and needs.
- Track and review member/participant satisfaction survey data regarding linguistic and/or cultural preferences and needs.
- Track and review employer/member requests and complaints regarding the Plan's ability to meet special linguistic and/or cultural preferences and needs.
ALL of the following
- Compile and analyze Diverse Population—Cultural and Linguistic Needs (including items above) and present the annual Population Assessment to the Quality Management Committee (QMC).
- Implement actions deemed necessary by the appropriate department(s) based on QMC review; conduct focused analyses (e.g., identify a specific health disparity to reduce, focus groups/interviews, chart reviews) when indicated, and provide training and tools to support culturally competent care.
Prevalence Threshold
Actions When Threshold Exceeded
Actions required when a language or cultural population exceeds >5%
If a non‑English language is the primary language for >5% of the population, providers must make translated member/participant materials available upon request, note practitioners who speak other languages in directories, and support adjustments to the practitioner network to meet members' linguistic and cultural needs.
- Provide translations of the Plan's required member/participant materials and make them available upon request in the identified prevalent language. [[source]]
- Note/designate practitioners who speak languages other than English in Practitioner Directories. [[source]]
- Review practitioner language/cultural backgrounds and take action to adjust the practitioner network if it does not meet member needs. [[source]]
- Notify Medicare Marketing that translated materials must be made available to members/participants when >5% speak a non‑English primary language. [[source]]
Definitions and Resources
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