The GLOBO Blog

The month of April introduced new procedural requirements for private sector employee benefit plans.

On April 1, 2018, the final rule amending the claims procedure for disability benefits plans under Section 503 of the Employee Retirement Income Security Act (ERISA) took effect.

Section 503 of ERISA outlines procedural requirements for employee benefit plans regarding the filing of benefit claims, notification of benefit determinations and appeal of adverse benefit determinations. The final rule amends the procedural requirements to include additional rules and protections for disability claimants, comparable to the protections for group health plan claims under the Affordable Care Act (ACA). 

When a 500-bed, independent medical center – known for superior patient care – was struggling to communicate with its diverse patient population, it partnered with GLOBO to centralize support and improve language access.

A Growing Need for Language Support

Located in an urban area with a highly-diverse population, the medical center recognized that providing culturally and linguistically appropriate services was central to the delivery of safe, equitable, high-quality patient care. However, the medical center's Director of Patient Relations feared its use of multiple language services vendors was jeopardizing its ability to provide meaningful access throughout the facility.

The healthcare industry’s shift to value-based care is well underway. The model advocates improving outcomes for acute and chronic patients through evidence-based, cost-effective care. Part of improving patients’ health outcomes is ensuring your medical staff can clearly communicate with every patient, regardless of language. Providing

At 18 percent of the U.S. gross domestic product, the healthcare industry is a mammoth web that ties together for-profit and nonprofit health systems, insurance companies, government agencies and consumers. Still, even the slightest shift in thinking--like moving from doctor-centric decision making to patient-centered care--can cause rippling effects throughout the industry.

The Institute of Medicine defines patient-centered care as “respectful of and responsive to

The final ruling of Section 1557 of the Affordable Care Act (ACA) put major changes in motion regarding individuals’ ability to access health care and coverage. The law prohibits discrimination based on age, sex, disability, race, color and national origin, which includes the language an individual speaks.

The enhancement of language assistance for individuals classified as Limited English Proficient (those who speak English less than "very well”) is just one piece of the puzzle in the law's efforts to reduce disparities in healthcare. Since the final rule was implemented, language services have been a hot topic for many health insurers and providers. However, the rule, which is extensively outlined in a whopping 99-page document, isn’t entirely easy to digest.

Questions such as ‘Does Section 1557 affect me?’ and ‘How do I comply with the language access requirements?’ often arise. To help make sense of the law (and answer these questions), we’re breaking down exactly who the law affects, and how those affected can become compliant with the language access requirements, with two simple flowcharts: