Current through Register 2024 Notice Reg. No. 38, September 20, 2024
(a) Every health insurer shall monitor the
implementation and provision of its LAP and make modifications as necessary to
ensure compliance with Insurance Code sections
10133.8 and
10133.9 and
these regulations. The health insurer's policies and procedures shall include a
description of the health insurer's method of (1) monitoring health insurer,
contractor, health care provider, and network compliance with the health insurer's
standards for the LAP Assistance Program, including the availability, quality and
utilization of language assistance services, (2) tracking grievances and complaints
related to its LAP Assistance Program, and (3) documenting actions taken to correct
problems.
(b) Every health insurer shall
evaluate the effectiveness of its LAP with regard to the following:
(1) Assessing indicated/threshold language(s)
based on data collected;
(2) Assessing
current language assistance needs of its insureds who are LEP persons;
(3) Documenting and responding to requests for
translation and interpretation services;
(4) Whether the existing LAP Assistance Program
meets the needs of its insureds who are LEP insureds;
(5) Whether health insurer staff know the health
insurer's policies and procedures and how to implement them;
(6) Whether the resources and arrangements for
language assistance identified in the health insurer's policies and procedures are
still current and available; and
(7)
Responding to communications from insureds, including via surveys and
complaints.
(c) Every health
insurer shall report the information and data requested by the Department of
Insurance in a timely manner. Health insurers who do not report in a timely manner
shall be subject to fines and penalties as authorized by the Insurance Code.
(1) By December 1, 2007, every health insurer
shall report to the Department of Insurance on the status of the implementation of
its LAP Assistance Program;
(2) Within
one year after the health insurer's initial assessment but no later than December 1,
2009 and biennially by December 1st thereafter, every health insurer shall report to
the Department of Insurance on its internal policies and procedures related to
cultural appropriateness and any other information related to the health insurer's
LAP as requested by the Commissioner, in a format specified by the department that
shall include at least the following information:
(A) The data regarding the insured population
based on the needs assessment as required by paragraph (2) of subdivision (b) of
Insurance Code section
10133.8;
(B) The education of health insurer staff who have
routine contact with insureds regarding the diverse needs of the insured
population;
(C) The health insurer's
recruitment and retention efforts that encourage workforce diversity;
(D) An evaluation of the health insurer's language
assistance programs and services with respect to the health insurer's insured
population, using processes such as an analysis of complaints and satisfaction
survey results;
(E) The periodic
provision of information regarding the ethnic diversity of the health insurer's
insured population and any related strategies to health insurer's providers. Health
insurers may use existing means of communication;
(F) The periodic provision of educational
information to insureds on the health insurer's services and
programs.
1. New section
filed 9-19-2007; operative 10-19-2007 (Register 2007, No.
38).
Note: Authority cited: Sections
10133.8 and
10133.9,
Insurance Code. Reference: Sections
10133.8 and
10133.9,
Insurance Code.
