Sec. 10.67.05.01. Access Standards: Addressing Enrollees' Individualized Needs

A. An MCO shall provide access to health care services and information in a manner that addresses the individualized needs of its enrollees, regardless of gender, sexual orientation, or gender identity, including, but not limited to, the delivery of services and information to enrollees:

(1) In a culturally sensitive manner;

(2) At an appropriate reading comprehension level;

(3) In the prevalent non-English languages identified by the State; and

(4) In a manner that accommodates individuals with disabilities consistent with the requirements of the Americans with Disabilities Act of 1990, P.L. 101-330, 42 U.S.C. §12101 et seq., and regulations promulgated under it.

B. Special Access.

(1) An MCO shall notify enrollees of the following services and make them available free of charge to the enrollee:

(a) Written materials in the prevalent non-English languages identified by the State;

(b) Written materials in alternative formats;

(c) Oral interpretation services in all non-English languages; and

(d) Auxiliary aids and services, such as:

(i) Teletypewriter/Telecommunication Device for the Deaf (TTY/TDD); and

(ii) American Sign Language.

(2) An MCO shall include taglines with its written materials that:

(a) Explain the availability of written translation or oral interpretation to understand the information provided; and

(b) Provide the toll-free and TTY/TDD telephone number of the MCO’s customer service unit.

(3) An MCO shall format taglines included with written materials in the following manner:

(a) In a font size no smaller than 18 point; and

(b) In the prevalent non-English languages identified by the State.

C. Written Materials. An MCO shall provide all its written materials in the following manner:

(1) Using language and a format that is easily understood;

(2) In a font size no smaller than 12 point;

(3) Available in alternative formats and through the provision of auxiliary aids and services; and

(4) Available in an appropriate manner that takes into consideration the special needs of enrollees or potential enrollees with disabilities or limited English proficiency.

D. An MCO may provide enrollee information electronically so long as all of the following requirements are met:

(1) The format is readily accessible;

(2) The information is placed in a location on the MCO’s website that is prominent and readily accessible;

(3) The information is provided in an electronic form which can be electronically retained and printed;

(4) The information is consistent with the content and language requirements of this section;

(5) The enrollee is informed that the information is available in paper form without charge upon request; and

(6) Should the enrollee request it, the MCO provides the information in paper form within 5 business days.