Civil Rights and Cultural Competence

In general, contracts require managed care organizations (MCOs) to provide services with appropriate consideration of consumers’ cultural status. This requirement includes providing written materials in languages other than English, and making translators available as necessary.

Like any business, an MCO must also comply with the Americans with Disabilities Act. This obligation is stated explicitly in some of the state contracts with MCOs.

Cultural Competence

  • MCO must develop Cultural Competency Plan (CCP) that describes education, training, services, and translation, and must conduct annual assessment of such CCP: Arizona a, Florida b, Hawaii c, New Mexico d, Texas e
  • Network providers must be responsive to linguistic, cultural, ethnic or other unique needs: Massachusetts f
  • MCO annually must evaluate effectiveness of CCP based on surveys, provider feedback, and consumer grievances and appeals: Florida g, New Mexico h
  • MCO must have diverse staff: New Mexico i
  • MCOs must assess consumers’ language preferences and cultural expectations: Hawaii j, New Mexico k
  • MCO must allow consumers to choose providers based upon cultural preference: Kansas l, Wisconsin m
  • Appeals and grievances process must be able to address deficiencies in culturally appropriate care: Kansas n, Wisconsin o

Language Access

  • MCO must provide free oral translation services to consumers regardless of language’s prevalence, and notify consumers how to access such services: Arizona p, Florida q, Hawaii r, Kansas s, New Mexico t, New York u, New York Partnership v, Tennessee w, Wisconsin x
  • Written materials must be at 6th-7th grade reading level or below: Hawaii y, Minnesota ``, New Mexico aa, New York bb
  • MCO must provide services to facilitate communication with consumers who have hearing or visual impairments: Florida cc, Hawaii dd, Massachusetts ee, Minnesota ff, New Mexico gg, New York hh, New York Partnership ii, Tennessee jj, Texas kk
  • MCO must translate documents into “prevalent languages,” which are those spoken by at least five percent of the enrolled population: New Mexico ll, New York Partnership mm
  • MCO must translate documents into languages spoken by 10 percent of enrolled population or at least 3,000 enrolled consumers, whichever is less. For “vital” documents, threshold is reduced to 5 percent or 1,000 enrolled consumers: Arizona nn, Minnesota oo
  • MCO provider directories must identify languages spoken by participating providers: Florida pp, Kansas qq, New York rr, New York Partnership ss
  • MCO must submit report to state that documents consumer requests for language translation and for documents in non-English languages: Hawaii tt


  • MCO policies must comply with Americans with Disabilities Act: Minnesota uu, New Mexico vv, New York ww, New York Partnership xx
  1. Ariz. Contract, p. 104  (back)
  2. Fla. Contract, Atch. II, p. 92.  (back)
  3. Haw. RFP, p. 164.  (back)
  4. N.M. Contract, pp. 72-74.  (back)
  5. Tex. Contract, p. 8-44.  (back)
  6. Mass. Contract, p. 41.  (back)
  7. Fla. Contract, Atch. II, p. 92.  (back)
  8. N.M. Contract, p. 73.  (back)
  9. N.M. Contract, p. 73.  (back)
  10. Haw. RFP, p. 164.  (back)
  11. N.M. Contract, p. 73.  (back)
  12. Kan. RFP, p. 41.  (back)
  13. Wis. Contract, p. 112.  (back)
  14. Kan. RFP, p. 41.  (back)
  15. Wis. Contract, p. 113.  (back)
  16. Ariz. Contract, p. 42.  (back)
  17. Fla. Contract, Atch. II, p. 57.  (back)
  18. Haw. RFP, pp. 198-99.  (back)
  19. Kan. RFP, p. 60.  (back)
  20. N.M. Contract, p. 30.  (back)
  21. N.Y. Medicaid Advantage Plus Contract, Sect. 12, p. 2.  (back)
  22. N.Y. Partnership Contract, Appendix M, p. 2.  (back)
  23. Tenn. Contract, pp. 274-75, 285.  (back)
  24. Wis. Contract, p. 136.  (back)
  25. Haw. RFP, p. 188.  (back)
  26. Minn. Contract, p. 46.  (back)
  27. N. M. Contract, p. 29.  (back)
  28. N.Y. Medicaid Advantage Plus Contract, Sect. 13, p. 1.  (back)
  29. Fla. Contract, Atch. II, pp. 49, 56.  (back)
  30. Haw. RFP, pp. 198-99.  (back)
  31. Mass. Contract, p. 39.  (back)
  32. Minn. Contract, p. 140.  (back)
  33. N.M. Contract, p. 30.  (back)
  34. N.Y. Medicaid Advantage Plus Contract, Sect. 12, p. 3.  (back)
  35. N.Y. Partnership Contract, Appendix M, p. 2.  (back)
  36. Tenn. Contract, pp. 283, 552.  (back)
  37. Tex. Contract, p. 8-25.  (back)
  38. N.M. Contract, p. 30.  (back)
  39. N.Y. Partnership Contract, Appendix M, p. 1.  (back)
  40. Ariz. Contract, p. 42.  (back)
  41. Minn. Contract, p. 46.  (back)
  42. Fla. Contract, Atch. II, p. 55.  (back)
  43. Kan. RFP, p. 61.  (back)
  44. N.Y. Medicaid Advantage Plus Contract, Sect. 12, p. 2.  (back)
  45. N.Y. Partnership Contract, Appendix M, p. 3.  (back)
  46. Haw. RFP, p. 258.  (back)
  47. Minn. Contract, p. 216.  (back)
  48. N.M. Contract, p. 28.  (back)
  49. N.Y. Medicaid Advantage Plus Contract, Sect. 23 (referencing guidelines for ADA compliance in Appendix J).  (back)
  50. N.Y. Partnership Contract, p. 70, Appendix B – guidelines for ADA compliance.  (back)

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