22-211 Updated Translation Requirements for Medi-Cal Notice of Action
Date: 03/11/22
This information applies to Participating Physician Groups (PPGs).
For Medi-Cal, this information applies to Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus, and Tulare counties.
PPGs to coordinate clinical translations in the NOA for Health Net Medi-Cal members.
Per All Plan Letter 21-0111, all Medi-Cal Notice of Actions (NOA) must be fully translated into the member’s preferred language in the initial notification. This includes all content, including clinical rationale for the denial, delay, modification, or termination of treatment or service.
Prior to February 27, 2022 | No later than February 28, 20222 |
|---|---|
May send the pre-translated NOA to the member, with the member specific information in English. | Must send the NOA to the member fully translated, including the member specific information, in the member’s preferred language. |
Must send a fully translated version of the NOA to the member within 30 days of the initial notification. | Fully translated notification must adhere to timeliness requirements per Health and Safety Code (HSC) 1367.01 and National Committee for Quality Assurance (NCQA) guidelines for member notification. |
Include verbiage in pre-translated template that informs the member that they will receive the fully translated version within 30 days. | Remove verbiage specific to receiving a translated version within 30 days from the NOA. This is no longer applicable. |
1 For more information, refer to DHCS all plan letter 21-011 – Grievance and Appeal Requirements, Notice, and “Your Rights” Templates.
2 May start sending fully translated NOA in the initial member notification prior to February 28, 2022.
PPG Translation requirements and oversight
Starting immediately, participating physician groups (PPGs), delegated for Medi-Cal utilization management functions, must coordinate getting the specific individualized text inserted in the NOA letter translated in members’ preferred languages.
Health Net will cover translation costs of the NOA when the below criteria are met:
- Must be for Health Net Medi-Cal member NOA translations only.
- Must use current Health Net pre-translated NOA template (available at www.iceforhealth.org/home.asp).
- Must use Health Net’s preferred translation vendor, Akorbi Language Consulting (Akorbi).
As part of your annual utilization management compliance audit, you may be asked to provide a log of all Medi-Cal authorizations requiring translation. These logs can be used to select translated samples to review as part of the audit scope.
Access to Akorbi
You must set up a Health Net specific account to submit requests for translations for our members. If you have not been contacted to set-up your account, please reach out for assistance.
How to request translations from Akorbi Plunet portal
PPGs are responsible to ensure letters are submitted with enough time to complete the translation and meet the timeliness requirements for member notification.
After your account is created, follow the steps below to submit Medi-Cal NOA letters for translation:
- Enter each letter as a separate request through the secure website.
- Enter the following information to complete your request
- Project name (e.g., APL 21 011_Denial_00284743_24hours) – must include the elements below:
- APL 21 011.
- Template type – use options: Carve Out, Delay, Denial, Modify or Terminate.
- Authorization number.
- Turnaround time (TAT) requested – Enter the necessary TAT to meet timeline requirements for notification.
- Enter the member ID number into the Reference Number field.
- Select the product line, including the plan name (Health Net Medi-Cal, Molina Medi-Cal).
- Select your PPG name from the Department drop down list.
- Follow the prompts to upload your letter and select the requested language. Use the appropriate pre-translated letter template, inserting the member specific information in English, for your request.
- You will receive an email to login and download your letter after it has been translated. Due to the nature of the information in the letters, these translated documents will not be sent via email.
- Translated letters are archived after 60 days. If you need a copy of an old NOA, you can request this directly from Akorbi.
No other document translations should be submitted through this process.
Akorbi Plunet portal training guide
A user guide for the Akorbi Plunet portal can be found in the Provider Library > Forms and References > Notice of Action Letter Translations: Akorbi Plunet Portal. Password reset or login questions should be submitted directly through the Plunet portal.