Notice of Nondiscrimination

When the plan makes decisions about employment of staff or provides health care services, it does not discriminate based on a person's race, disability, religion, sex, sexual orientation, ethnicity, creed, age, national origin, or any factor that is related to health status, including, but not limited to the following:

• Medical condition, including mental as well as physical illness
• Claims experience
• Receipt of health care
• Medical history
• Genetic information
• Evidence of insurability, including conditions arising out of acts of domestic violence
• Disability

Additionally, participating providers must have practice policies that demonstrate that they accept for treatment any member in need of the health care services they provide.

All organizations that provide Medicare managed care, including Health Net Community Solutions, Inc. and its participating providers, must obey federal laws against discrimination, including Title VI of the Civil Rights Act of 1964, the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, the Americans with Disabilities Act (ADA), Section 1557 of the Affordable Care Act of 2010 (ACA), and all other laws that apply to organizations that receive federal funding, and any other laws and rules that apply for any other reason.

For additional information regarding eligibility and enrollment criteria, refer to the Enrollment and Eligibility topics.

In accordance with Section 1557 of the Affordable Care Act of 2010 (ACA), the following requirements apply:

• Participating providers must add plan-specific nondiscrimination notices and taglines in significant publications and communications issued to members.
• If necessary, participating providers must assess and enhance existing policies and procedures to ensure effective communication with members.
• Participating providers must ensure programs or activities provided through electronic or information technology, such as websites or online versions of materials, are accessible to individuals with disabilities. If necessary, participating providers must assess and enhance website compliance with Title II of the ADA.
• Participating providers must notify the plan immediately of a discrimination grievance submitted by a member and continue to follow the plan's existing issue write-up procedures for detection and remediation of non-compliance. Additionally, participating providers must comply with the plan, regulatory or private litigation research, investigations, and remediation requirements.
• Participating providers must assess and enhance, if necessary, existing language assistance services to ensure they are compliant.
• Participating providers must implement, enhance and reinforce prohibitions on exclusions, denials or discrimination such as in design, operation or behavior of benefits or services on the basis of race, color, national origin, sex, age, or disability. Additionally, they must implement, where applicable:
  • Medical necessity reviews for all gender transition services and surgery.
  • Program or activity changes to avoid discrimination where necessary.
  • Plan design changes where necessary, such as removing categorical gender or age exclusions.
  • Additionally, providers must remove prohibited categorical exclusions and denial reasons, and update nondiscrimination policies and procedures to include prohibitions against discrimination on the basis of sex, including gender identity and sex stereotyping.
• Participating providers can consider implementing the following:
  • Ability to capture gender identity.
  • Mandatory provider and staff civil rights and/or cultural sensitivity training.