‘‘(13) ensure that, consistent with the privacy 
protections provided for under the regulations pro-
mulgated under section 264(c) of the Health Insur-
ance Portability and Accountability Act of 1996 (42 
U.S.C. 1320d–2 note), and any applicable State pri-
vacy laws, data on the individual patient or recipi-
ent’s race, ethnicity, and primary language are col-
lected (and periodically updated) in health records 
and integrated into the organization’s information 
management systems or any similar system used to 
store and retrieve data. 
‘‘(d) PRIORITY.—In awarding grants under this sec-
tion, the Secretary shall give priority to entities that pri-
marily engage in providing direct care and that have devel-
oped partnerships with community organizations or with 
agencies with experience language access. 
‘‘(e) EVALUATION.— 
‘‘(1) An entity that receives a grant under this 
section shall submit to the Secretary an evaluation 
that describes, in the manner and to the extent re-
quired by the Secretary, the activities carried out 
with funds received under the grant, and how such 
activities improved access to health and health-care- 
related services and the quality of health care for in-
dividuals with limited-English proficiency. Such eval-
VerDate Mar 15 2010 
03:50 Sep 21, 2011
Jkt 099200
PO 00000
Frm 00093
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
uation shall be collected and disseminated through 
the Robert T. Matsui Center for Cultural and Lin-
guistic Competence in Health Care established under 
section 3403. The Director of the Agency for 
Healthcare Research and Quality shall notify grant-
ees of the availability of technical assistance for the 
evaluation and provide such assistance upon request. 
‘‘(2) The Director of the Agency for Healthcare 
Research and Quality shall evaluate or arrange with 
other individuals or organizations to evaluate 
projects funded under this section. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section, 
$5,000,000 for each of fiscal years 2012 through 2016. 
‘‘SEC. 3405. RESEARCH ON CULTURAL AND LANGUAGE COM-
PETENCE. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Agency for Healthcare Research and 
Quality, shall expand research concerning language access 
in the provision of health care. 
‘‘(b) ELIGIBILITY.—The Director of the Agency for 
Healthcare Research and Quality may conduct the re-
search described in subsection (a) or enter into contracts 
with other individuals or organizations to do so. 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00094
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
‘‘(c) USE OF FUNDS.—Research under this section 
shall be designed to do one or more of the following: 
‘‘(1) To identify the barriers to mental and be-
havioral services that are faced by LEP individuals. 
‘‘(2) To identify health care providers’ and 
health administrators’ attitudes, knowledge, and 
awareness of the barriers to quality health care serv-
ices that are faced by LEP individuals. 
‘‘(3) To identify optimal approaches for deliv-
ering language access. 
‘‘(4) To identify best practices for data collec-
tion, including— 
‘‘(A) the collection by providers of health 
care and health-care-related services of data on 
the race, ethnicity, and primary language of re-
cipients of such services, taking into account ex-
isting research conducted by the Government or 
private sector; 
‘‘(B) the development and implementation 
of data collection and reporting systems; and 
‘‘(C) effective privacy safeguards for col-
lected data. 
‘‘(5) To develop a minimum data collection set 
for primary language. 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00095
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
‘‘(6) To evaluate the most effective ways in 
which the Department can create or coordinate, and 
then subsidize or otherwise fund telephonic interpre-
tation providers for health care providers, taking 
into consideration, among other factors, the flexi-
bility necessary for such a system to accommodate 
variations in— 
‘‘(A) provider type; 
‘‘(B) languages needed and their frequency 
of use; 
‘‘(C) type of encounter; 
‘‘(D) time of encounter, including regular 
business hours and after hours; and 
‘‘(E) location of encounter. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section, 
such sums as may be necessary for each of fiscal years 
2012 through 2016.’’. 
SEC. 203. FEDERAL REIMBURSEMENT FOR CULTURALLY 
AND LINGUISTICALLY APPROPRIATE SERV-
ICES UNDER THE MEDICARE, MEDICAID, AND 
STATE 
CHILDREN’S 
HEALTH 
INSURANCE 
PROGRAMS. 
(a) LANGUAGE ACCESS GRANTS
FOR MEDICARE 
PROVIDERS.— 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00096
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
(1) ESTABLISHMENT.— 
(A) IN
GENERAL.—Not later than 6 
months after the date of the enactment of this 
Act, the Secretary of Health and Human Serv-
ices, acting through the Centers for Medicare & 
Medicaid Services and in consultation with the 
Center for Medicare and Medicaid Innovation, 
shall establish demonstration program under 
which the Secretary shall award grants to eligi-
ble Medicare service providers to improve com-
munication between such providers and limited- 
English-proficient Medicare beneficiaries, in-
cluding beneficiaries who live in diverse and un-
derserved communities. 
(B) 
APPLICATION
OF
INNOVATION 
RULES.—The demonstration project under sub-
paragraph (A) shall be conducted in a manner 
that is consistent with the applicable provisions 
of subsections (b), (c), and (d) of section 1115A 
of the Social Security Act. 
(C) NUMBER OF GRANTS.—To the extent 
practicible, the Secretary shall award not less 
than 24 grants under this subsection. 
(D) GRANT PERIOD.—Except as provided 
under paragraph (2)(D), each grant awarded 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00097
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
under this subsection shall be for a 3-year pe-
riod. 
(2) ELIGIBILITY REQUIREMENTS.—To be eligi-
ble for a grant under this subsection, an entity must 
meet the following requirements: 
(A) MEDICARE
PROVIDER.—The entity 
must be— 
(i) a provider of services under part A 
of title XVIII of the Social Security Act; 
(ii) a provider of services under part 
B of such title; 
(iii) a Medicare Advantage organiza-
tion offering a Medicare Advantage plan 
under part C of such title; or 
(iv) a PDP sponsor offering a pre-
scription drug plan under part D of such 
title. 
(B) UNDERSERVED
COMMUNITIES.—The 
entity must serve a community that with re-
spect to necessary langauge services for improv-
ing access and utilization of health care amoung 
limited-English 
proficienct 
individuals, 
is 
disproportinaly underserved. 
(C) APPLICATION.—The entity must pre-
pare and submit to the Secretary an applica-
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00098
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
100 
(A) VARIATION IN GRANTEES.—In award-
ing grants under this subsection, the Secretary 
shall select grantees to ensure the following: 
(i) The grantees provide many dif-
ferent types of language services. 
(ii) The grantees serve Medicare bene-
ficiaries who speak different languages, 
and who, as a population, have differing 
needs for language services. 
(iii) The grantees serve Medicare 
beneficiaries in both urban and rural set-
tings. 
(iv) The grantees serve Medicare 
beneficiaries in at least two geographic re-
gions, as defined by the Secretary. 
(v) The grantees serve Medicare bene-
ficiaries in at least two large metropolitan 
statistical areas with racial, ethnic, and 
economicly diverse populations. 
(B) PRIORITY
FOR
PARTNERSHIPS
WITH 
COMMUNITY ORGANIZATIONS AND AGENCIES.— 
In awarding grants under this subsection, the 
Secretary shall give priority to eligible entities 
that have a partnership with— 
(i) a community organization; or 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00100
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
101 
(ii) 
a 
consortia 
of 
community 
origanizations, state agecenices, and local 
agencies, 
that has experience in providing language serv-
ices. 
(5) USE OF FUNDS FOR COMPETENT LANGUAGE 
SERVICES.— 
(A) IN
GENERAL.—Subject to subpara-
graph (E), a grantee may only use grant funds 
received under this subsection to pay for the 
provision of competent language services to 
Medicare beneficiaries who are limited-English 
proficient. 
(B) COMPETENT LANGUAGE SERVICES DE-
FINED.—For purposes of this subsection, the 
term ‘‘competent language services’’ means— 
(i) interpreter and translation services 
that— 
(I) subject to the exceptions 
under subparagraph (C)— 
(aa) if the grantee operates 
in a State that has statewide 
health care interpreter standards, 
meet the State standards cur-
rently in effect; or 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00101
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
102 
(bb) if the grantee operates 
in a State that does not have 
statewide health care interpreter 
standards, utilizes competent in-
terpreters who follow the Na-
tional Council on Interpreting in 
Health Care’s Code of Ethics and 
Standards of Practice; and 
(II) that, in the case of inter-
preter 
services, 
are 
provided 
through— 
(aa) on-site interpretation; 
(bb) telephonic interpreta-
tion; or 
(cc) 
video 
interpretation; 
and 
(ii) the direct provision of health care 
or health-care-related services by a com-
petent bilingual health care provider. 
(C) EXCEPTIONS.—The requirements of 
subparagraph (B)(i)(I) do not apply— 
(i) to a Medicare beneficiary who is 
limited-English-proficient who has been in-
formed, in the beneficiary’s primary lan-
guage, of the availability of free interpreter 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00102
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
103 
and translation services and who, instead, 
requests that a family member, friend, or 
other person provide such services, if the 
grantee documents such request in the 
beneficiary’s medical record; or 
(ii) in the case of a medical emergency 
where the delay directly associated with ob-
taining a competent interpreter or trans-
lation services would jeopardize the health 
of the patient. 
Subparagraph (C)(ii) shall not be construed to 
exempt emergency rooms or similar entities 
that regularly provide health care services in 
medical emergencies to limited-English-pro-
ficient patients from any applicable legal or reg-
ulatory requirements related to providing com-
petent interpreter and translation services with-
out undue delay. 
(D) MA ORGANIZATIONS AND PDP SPON-
SORS.—If a grantee is a MA organization or a 
PDP sponsor, such entity must provide at least 
50 percent of the grant funds that the entity 
receives under this subsection directly to the en-
tity’s network providers (including physicians 
and pharmacies) for the purpose of providing 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00103
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
104 
support for such providers to provide competent 
language services to Medicare beneficiaries who 
are limited-English proficient. 
(E) ADMINISTRATIVE
AND
REPORTING 
COSTS.—A grantee may use up to 10 percent of 
the grant funds to pay for administrative costs 
associated with the provision of competent lan-
guage services and for reporting required under 
paragraph (9). 
(6) DETERMINATION
OF
AMOUNT
OF
GRANT 
PAYMENTS.— 
(A) IN GENERAL.—Payments to grantees 
under this subsection shall be calculated based 
on the estimated numbers of limited-English- 
proficient Medicare beneficiaries in a grantee’s 
service area utilizing— 
(i) data on the numbers of limited- 
English-proficient individuals who speak 
English less than ‘‘very well’’ from the 
most recently available data from the Bu-
reau of the Census or other State-based 
study the Secretary determines likely to 
yield accurate data regarding the number 
of such individuals in such service area; or 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00104
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
105 
(ii) data provided by the grantee, if 
the grantee routinely collects data on the 
primary language of the Medicare bene-
ficiaries that the grantee serves and the 
Secretary determines that the data is accu-
rate and shows a greater number of lim-
ited-English-proficient 
individuals 
than 
would be estimated using the data under 
clause (i). 
(B) DISCRETION OF SECRETARY.—Subject 
to subparagraph (C), the amount of payment 
made to a grantee under this subsection may be 
modified annually at the discretion of the Sec-
retary, based on changes in the data under sub-
paragraph (A) with respect to the service area 
of a grantee for the year. 
(C) 
LIMITATION
ON
AMOUNT.—The 
amount of a grant made under this subsection 
to a grantee may not exceed $500,000 for the 
period under paragraph (1)(D). 
(7) ASSURANCES.—Grantees under this sub-
section shall— 
(A) ensure that clinical and support staff 
receive appropriate ongoing education and 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00105
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
106 
training in linguistically appropriate service de-
livery; 
(B) ensure the linguistic competence of bi-
lingual providers; 
(C) offer and provide appropriate language 
services at no additional charge to each patient 
with limited-English proficiency for all points of 
contact between the patient and the grantee, in 
a timely manner during all hours of operation; 
(D) notify Medicare beneficiaries of their 
right to receive language services in their pri-
mary language; 
(E) post signage in the primary languages 
commonly used by the patient population in the 
service area of the organization; and 
(F) ensure that— 
(i) primary language data is collected 
for recipients of language services and 
such data is consistent with standards de-
veloped under title XXXIV of the Public 
Health Service Act, as added by section 
202 of this Act, to the extent such stand-
ards are available upon the initiation of the 
demonstration program; and 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00106
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
107 
(ii) consistent with the privacy protec-
tions provided under the regulations pro-
mulgated pursuant to section 264(c) of the 
Health Insurance Portability and Account-
ability Act of 1996 (42 U.S.C. 1320d–2 
note), if the recipient of language services 
is a minor or is incapacitated, primary lan-
guage data is collected on the parent or 
legal guardian of such recipient. 
(8) NO COST SHARING.—Limited-English-pro-
ficient Medicare beneficiaries shall not have to pay 
cost-sharing or co-payments for competent language 
services provided under this demonstration program. 
(9) REPORTING
REQUIREMENTS
FOR
GRANT-
EES.—Not later than the end of each calendar year, 
a grantee that receives funds under this subsection 
in such year shall submit to the Secretary a report 
that includes the following information: 
(A) The number of Medicare beneficiaries 
to whom competent language services are pro-
vided. 
(B) The primary languages of those Medi-
care beneficiaries. 
(C) The types of language services pro-
vided to such beneficiaries. 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00107
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
108 
(D) Whether such language services were 
provided by employees of the grantee or 
through a contract with external contractors or 
agencies). 
(E) The types of interpretation services 
provided to such beneficiaries, and the approxi-
mate length of time such service is provided to 
such beneficiaries. 
(F) The costs of providing competent lan-
guage services. 
(G) An account of the training or accredi-
tation of bilingual staff, interpreters, and trans-
lators providing services funded by the grant 
under this subsection. 
(10) EVALUATION
AND
REPORT
TO
CON-
GRESS.—Not later than 1 year after the completion 
of a 3-year grant under this subsection, the Sec-
retary shall conduct an evaluation of the demonstra-
tion program under this subsection and shall submit 
to the Congress a report that includes the following: 
(A) An analysis of the patient outcomes 
and the costs of furnishing care to the limited- 
English-proficient Medicare beneficiaries par-
ticipating in the project as compared to such 
outcomes and costs for limited-English-pro-
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00108
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
109 
ficient Medicare beneficiaries not participating, 
based on the data provided under paragraph (9) 
and any other information available to the Sec-
retary. 
(B) The effect of delivering langauge serv-
ices on— 
(i) Medicare beneficiary access to care 
and utilization of services; 
(ii) the efficiency and cost effective-
ness of health care delivery; 
(iii) patient satisfaction; 
(iv) health outcomes; and 
(v) the provision of culturally appro-
priate 
services 
provided 
to 
such 
benificiaries. 
(C) The extent to which bilingual staff, in-
terpreters, and translators providing services 
under such demonstration were trained or ac-
credited and the nature of accreditation or 
training needed by type of provider, service, or 
other category as determined by the Secretary 
to ensure the provision of high-quality interpre-
tation, translation, or other language services to 
Medicare beneficiaries if such services are ex-
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00109
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
110 
panded pursuant to subsection (c) of section 
1907 of this Act. 
(D) Recommendations, if any, regarding 
the extension of such project to the entire Medi-
care program, subject the to provision of section 
1115A(c) of the Social Security Act. 
(11) APPROPRIATIONS.—There is appropriated 
to carry out this subsection, in equal parts from the 
Federal Hospital Insurance Trust Fund and the 
Federal Supplementary Medical Insurance Trust 
Fund, $16,000,000 for each fiscal year of the dem-
onstration program. 
(b) LANGUAGE SERVICES UNDER THE MEDICARE 
PROGRAM.— 
(1) Subsection (aa)(1) of section 1861 of the 
Social Security Act (42 U.S.C. 1395x) is amended— 
(A) in subparagraph (B), by striking the 
‘‘and’’ at the end; 
(B) in subparagrpah (C), by inserting 
‘‘and’’ after the comma at the end; and 
(C) by inserting after subparagraph (C) 
the following: 
‘‘(D) language services as defined in sub-
section (iii),’’. 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00110
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
111 
(2) Section 1833(a) of the Social Security Act 
(42 U.S.C. 1395l(a)) is amended— 
(A) by striking ‘‘and’’ at the end of para-
graph (8); 
(B) by edesignating paragraph (9) as para-
graph (10); and 
(C) by inserting after paragraph (8) the 
following new paragraph: 
‘‘(9) in the case of language services described 
in section 1861(iii), 100 percent of the reasonable 
charges for such services, as determined in consulta-
tion with the Medicare Payment Advisory Commis-
sion; and’’. 
(3) Section 1832(a)(2) of such Act (42 U.S.C. 
1395k(a)(2)) is amended— 
(A) by striking ‘‘and’’ at the end of sub-
paragraph (I); 
(B) by striking the period at the end of 
subparagraph (J) and inserting ‘‘; and’’; and 
(C) by adding at the end of subparagraph 
(J) the following: 
‘‘(K) language services (as defined in sec-
tion 1861(iii)) furnished by a interpreter or 
translator.’’. 
VerDate Mar 15 2010 
03:50 Sep 21, 2011
Jkt 099200
PO 00000
Frm 00111
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
112 
(4) Section 1861 of the Social Security Act (42 
U.S.C. 1395x) is amended by adding at the end the 
following new subsection: 
‘‘Language Services and Related Terms 
‘‘(iii)(1) LANGUAGE SERVICES DEFINED.—The term 
‘language services’ has the same meaning given ‘language 
or langauge access services’ in section 3400 of the Public 
Health Service Act. 
‘‘(2) INTERPRETER SERVICES DEFINED.—For the 
purposes of this subsection, the term ‘interpreter services’ 
has the meaning given ‘competent interpreter services’ 
under section 3400(3) of the Public Health Service Act. 
‘‘(3) INTERPRETER DEFINED.—The term ‘inter-
preter’— 
‘‘(A) means an individual— 
‘‘(i) who faithfully, accurately, and objec-
tively transmits a spoken message from one lan-
guage into another language; and 
‘‘(ii) who knows health and health-related 
terminology in both languages; and 
‘‘(B) includes individuals who provide in-person, 
telephonic, and video interpretation. 
‘‘(4) TRANSLATION DEFINED.—The term ‘trans-
lation’ means the transmission of a written message in one 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00112
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
113 
language into a written message in another language that 
retains the intended meaning of the original message. 
‘‘(5) LIMITED-ENGLISH-PROFICIENT AND LEP DE-
FINED.—The 
terms 
‘Limited-English-proficient’ 
and 
‘LEP’ have the meaning given the term ‘limited english 
proficient’ under section 9101(25) of the Elementary and 
Secondary Education Act of 1965, except that subpara-
graphs (A), (B), and (D) of such section not apply.’’. 
(5) WAIVER
OF
BUDGET
NEUTRALITY.—For 
the 3-year period beginning on the date of enact-
ment of this section, the budget neutrality provision 
of section 1848(c)(2)(B)(ii) of the Social Security 
Act (42 U.S.C. 1395w–4(c)(2)(B)(ii)) shall not 
apply to language services (as such term is defined 
in section 1861(iii) of such Act). 
(c) MEDICARE PART C AND PART D.— 
(1) IN GENERAL.—Medicare Advantage plans 
under part C of the Social Security Act and Pre-
scription Drug Plans under part D of such Act shall 
provide effective language services to enrollees of 
such plans. 
(2) 
REPORTING
REQUIREMENTS.—Medicare 
Advantage and Prescription Drug plans shall annu-
ally submit to the Secretary of Health and Human 
Services a report that contains information on the 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00113
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
114 
plan’s internal policies and procedures related to re-
cruitment and retention efforts directed to workforce 
diversity and linquistically and culturally appropriate 
provision of services in each of the following con-
texts: 
(A) The collection of data in a manner 
that meets the requirements of title I of this 
Act, regarding the enrollee population. 
(B) Education of staff and contractors who 
have routine contact with enrollees regarding 
the various needs of the diverse enrollee popu-
lation. 
(C) Evaluation of the health plan’s lan-
guage services programs and services with re-
spect to the plan’s enrollee population, such as 
through analysis of complaints or satisfaction 
survey results. 
(D) Methods by which the plan provides to 
the Secretary information regarding the ethnic 
diversity of the plan’s enrollee population. 
(E) The periodic provision of educational 
information to plan enrollees on the plan’s lan-
guage services and programs. 
(d) IMPROVING LANGUAGE SERVICES IN MEDICAID 
AND SCHIP.— 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00114
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
115 
(1) Section 1903(a)(2)(E) of the Social Secu-
rity Act (42 U.S.C. 1396b(a)(2)(E)) is amended 
by— 
(A) striking ‘‘75’’ and inserting ‘‘90’’; 
(B) striking ‘‘translation or interpretation 
services’’ and inserting ‘‘language services’’; 
and 
(C) striking ‘‘children of families’’ and in-
serting ‘‘individuals’’. 
(2) Section 1902(a)(10)(A) of the Social Secu-
rity Act (42 U.S.C. 1396a(a)(10)(A)) is amended by 
striking ‘‘and (28)’’ and inserting ‘‘(28), and (29)’’. 
(3) Section 1905(a) of the Social Security Act 
(42 U.S.C. 1396d(a)) is amended by— 
(A) in paragraph (28), by striking ‘‘and’’ 
at the end; 
(B) by redesignating paragraph (29) as 
paragraph (30); and 
(C) by inserting after paragraph (28) the 
following new paragraph: 
‘‘(29) language services, as such term is defined 
in section 1861(iii), provided in a timely manner to 
limited-English-proficient individuals who need such 
services; and’’. 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00115
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
116 
(4) Section 1916(a)(2) of the Social Security 
Act (42 U.S.C. 1396o(2)) is amended by— 
(A) by striking ‘‘or’’ at the end of subpara-
graph (D); 
(B) by striking ‘‘; and’’ at the end of sub-
paragraph (E) and inserting ‘‘, or’’; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(F) language services described in section 
1905(a)(29); and’’. 
(5) Section 2103 of the Social Security Act (42 
U.S.C. 1397cc) is amended— 
(A) in subsection (a), in the matter before 
paragraph (1), by striking ‘‘ and (7)’’ and in-
serting ‘‘(7), and (9)’’; and 
(B) in subsection (c), by adding at the end 
the following new paragraph: 
‘‘(9) LANGUAGE SERVICES.—The child health 
assistance provided to a targeted low-income child 
shall include coverage of language services, as such 
term is defined in section 1861(iii), provided in a 
timely manner to limited-English-proficient individ-
uals who need such services.’’; and 
(C) in subsection (e)(2)— 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00116
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
117 
(i) in the heading, by striking ‘‘PRE-
VENTIVE’’ and inserting ‘‘CERTAIN’’; and 
(ii) by inserting ‘‘, subsection (c)(9),’’ 
after ‘‘subsection (c)(1)(C)’’. 
(6) Section 2110(a)(27) of the Social Security 
Act (42 U.S.C. 1397jj) is amended by striking 
‘‘translation’’ and inserting ‘‘language services as 
described in section 2103(c)(9)’’. 
(7) Pursuant to the reporting requirement de-
scribed in section 2107(b)(1) of the Social Security 
Act (42 U.S.C. 1397gg(b)(1)), the Secretary of 
Health and Human Services shall require that 
States collect data on— 
(A) the primary language of individuals re-
ceiving child health assistance under title XXI 
of the Social Security Act; and 
(B) in the case of such individuals who are 
minors or incapacitated, the primary language 
of the individual’s parent or guardian. 
(8) Section 2105 of the Social Security Act (42 
U.S.C. 1397ee(c)) is amended— 
(A) in subsection (a)(1) by striking ‘‘75’’ 
and inserting ‘‘90’’; and 
(B) in subsection (c)(2)(A), by inserting 
before the period ‘‘, except that expenditures 
VerDate Mar 15 2010 
03:50 Sep 21, 2011
Jkt 099200
PO 00000
Frm 00117
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
118 
pursuant to clause (iv) of subparagraph (D) of 
such paragraph shall not count towards this 
total’’. 
(e) FUNDING LANGUAGE SERVICES FURNISHED BY 
PROVIDERS OF HEALTH CARE AND HEALTH-CARE-RE-
LATED SERVICES THAT SERVE HIGH RATES OF UNIN-
SURED LEP INDIVIDUALS.— 
(1) PAYMENT OF COSTS.— 
(A) IN
GENERAL.—Subject to subpara-
graph (B), the Secretary of Health and Human 
Services shall make payments (on a quarterly 
basis) directly to eligible entities to support the 
provision of language services to limited- 
English-proficient individuals in an amount 
equal to an entity’s eligible costs (as defined 
under paragraph (3)) for such services for the 
quarter. 
(B) FUNDING.—Out of any funds in the 
Treasury not otherwise appropriated, there are 
appropriated to the Secretary of Health and 
Human Services such sums as may be nec-
essary for each of fiscal years 2012 through 
2016. 
(C) RELATION TO MEDICAID DSH.—Pay-
ments under this subsection shall not offset or 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00118
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
119 
reduce payments under section 1923 of the So-
cial Security Act, nor shall payments under 
such section be considered when determining 
uncompensated costs associated with the provi-
sion of language services. 
(2) ELIGIBLE
ENTITY.—In order to receive 
grants under this paragraph, an entity must— 
(A) be a Medicaid provider that is— 
(i) a physician; 
(ii) a hospital with a low-income utili-
zation 
rate 
(as 
defined 
in 
section 
1923(b)(3) of the Social Security Act (42 
U.S.C. 1396r–4(b)(3))) of greater than 25 
percent; or 
(iii) a federally qualified health center 
(as defined in section 1905(l)(2)(B) of the 
Social 
Security 
Act 
(42 
U.S.C. 
1396d(l)(2)(B))); 
(B) provide language services to at least 8 
percent of the entity’s total number of patients, 
not later than 6 months after the date of the 
enactment of the Act; and 
(C) prepare and submit an application to 
the Secretary, at such time, in such manner, 
and accompanied by such information as the 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00119
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
120 
Secretary may require to ascertain the entity’s 
eligibility for funding under this subsection. 
(3) ELIGIBLE COSTS DEFINED.— 
(A) IN GENERAL.—In this subsection, the 
term ‘‘eligible costs’’ means, with respect to an 
eligible entity that provides language services to 
LEP individuals, the product of— 
(i) the average per person cost of lan-
guage services, determined according to 
the methodology devised under subpara-
graph (B); and 
(ii) the number of limited-English-pro-
ficient individuals who are provided lan-
guage services by the entity and for whom 
no reimbursement is available for such 
services under the amendments made by 
subsections (a), (b), (c), or (d) or by pri-
vate health insurance. 
(B) METHODOLOGY.— 
(i) IN GENERAL.—The Secretary shall 
establish a methodology to determine the 
average per person cost of language serv-
ices. 
(ii) DIFFERENT ENTITIES.—In estab-
lishing such methodology, the Secretary 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00120
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
121 
may establish different methodologies for 
different types of eligible entities. 
(iii) NO
INDIVIDUAL
CLAIMS.—The 
Secretary may not require eligible entities 
to submit individual claims for language 
services for individual patients as a re-
quirement for payment under this sub-
section. 
(4) DATA COLLECTION INSTRUMENT.—For pur-
poses of this subsection, the Secretary shall create a 
standard data collection instrument that is con-
sistent with any existing reporting requirements by 
the Secretary or relevant accrediting organizations 
regarding the number of individuals to whom lan-
guage access are provided. 
(5) REPORTING REQUIREMENTS.—Entities re-
ceiving payment under this subsection shall provide 
the Secretary with a quarterly report on how the en-
tity used such funds. Such report shall contain ag-
gregate (and may not contain individualized) data 
collected using the instrument under paragraph (4) 
and shall otherwise be in a form and manner deter-
mined by the Secretary. 
(6) LANGUAGE
SERVICES.—For purposes of 
this subsection, the term ‘‘language services’’ has 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00121
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
122 
the meaning given such term in section 1861(iii) of 
the Social Security Act. 
(7) GUIDELINES AND REPORT.— 
(A) ESTABLISHMENT.—Not later than 6 
months after the date of enactment of this Act, 
the Secretary of Health and Human Services 
shall establish and distribute guidelines con-
cerning the implementation of this subsection. 
(B) REPORT.—Not later than 2 years after 
the date of enactment of this Act, and every 2 
years thereafter, the Secretary shall submit a 
report to Congress concerning the implementa-
tion of this subsection. 
(f) APPLICATION OF CIVIL RIGHTS ACT OF 1964 AND 
OTHER LAWS.—Nothing in this section shall be construed 
to limit otherwise existing obligations of recipients of Fed-
eral financial assistance under title VI of the Civil Rights 
Act of 1964 (42 U.S.C. 2000(d) et seq.) or other laws 
that protect the civil rights of individuals. 
(g) EFFECTIVE DATE.—The amendments made by 
this section shall take effect on October 1, 2011. 
SEC. 204. INCREASING UNDERSTANDING OF AND IMPROV-
ING HEALTH LITERACY. 
(a) IN GENERAL.—The Secretary, acting through the 
Director of the Agency for Healthcare Research and Qual-
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00122
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
123 
ity and the Administrator of the Health Resources and 
Services Administration, in consultation with the Director 
of the National Institute on Minority Health and Health 
Disparities and the Office of Minority Health, shall award 
grants to eligible entities to improve health care for pa-
tient populations that have low functional health literacy. 
(b) ELIGIBILITY.—To be eligible to receive a grant 
under subsection (a), an entity shall— 
(1) be a hospital, health center or clinic, health 
plan, or other health entity (including a nonprofit 
minority health organization or association); and 
(2) prepare and submit to the Secretary an ap-
plication at such time, in such manner, and con-
taining such information as the Secretary may re-
quire. 
(c) USE OF FUNDS.— 
(1) AGENCY FOR HEALTHCARE RESEARCH AND 
QUALITY.—Grants awarded under subsection (a) 
through the Agency for Healthcare Research and 
Quality shall be used— 
(A) to define and increase the under-
standing of health literacy; 
(B) to investigate the correlation between 
low health literacy and health and health care; 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00123
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
124 
(C) to clarify which aspects of health lit-
eracy have an effect on health outcomes; and 
(D) for any other activity determined ap-
propriate by the Director of the Agency. 
(2) HEALTH RESOURCES AND SERVICES ADMIN-
ISTRATION.—Grants awarded under subsection (a) 
through the Health Resources and Services Adminis-
tration shall be used to conduct demonstration 
projects for interventions for patients with low 
health literacy that may include— 
(A) the development of new disease man-
agement programs for patients with low health 
literacy; 
(B) the tailoring of existing disease man-
agement programs addressing mental, physical, 
oral, and behavioral health conditions for pa-
tients with low health literacy; 
(C) the translation of written health mate-
rials for patients with low health literacy; 
(D) the identification, implementation, and 
testing of low health literacy screening tools; 
(E) the conduct of educational campaigns 
for patients and providers about low health lit-
eracy; and 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00124
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
125 
(F) other activities determined appropriate 
by the Administrator of the Health Resources 
and Services Administration. 
(d) DEFINITIONS.—In this section, the term ‘‘low 
health literacy’’ means the inability of an individual to ob-
tain, process, and understand basic health information 
and services needed to make appropriate health decisions. 
(e) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section, 
such sums as may be necessary for each of fiscal years 
2012 through 2016. 
SEC. 205. ASSURANCES FOR RECEIVING FEDERAL FUNDS. 
(a) IN GENERAL.—Entities that receive Federal 
funds under sections 201 or 202 (including under the 
amendments made by such section), in order to ensure the 
right of LEP individuals to receive access to quality health 
care, shall— 
(1) ensure that appropriate clinical and support 
staff receive ongoing education and training in lin-
guistically appropriate service delivery; 
(2) offer and provide appropriate language serv-
ices at no additional charge to each patient with lim-
ited-English proficiency at all points of contact, in a 
timely manner during all hours of operation; 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00125
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
126 
(3) notify patients of their right to receive lan-
guage services in their primary language; and 
(4) utilize only competent interpreter or trans-
lation services which— 
(A) until adoption of the Interpreter and 
Translator Guidelines and Standards described 
in section 3403(c) of the Public Health Service 
Act, are defined in section 3400 of the Public 
Health Service Act; and 
(B) after adoption of the Interpreter and 
Translator Guidelines and Standards described 
in section 3403(c) of the Public Health Service 
Act, meet those guidelines and standards; 
(b) EXEMPTIONS.—The requirements of subsection 
(a)(4) shall not apply as follows: 
(1) When a patient (who has been informed in 
his or her primary language of the availability of 
free interpreter and translation services) requests 
the use of family, friends, or other persons untrained 
in interpretation or translation if the following con-
ditions are met: 
(A) The interpreter requested by the pa-
tient is over the age of 18. 
(B) The recipient informs the patient that 
he or she has the option of having the recipient 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00126
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
127 
provide an interpreter for him/her without 
charge, or of using his/her own interpreter. 
(C) The recipient informs the patient that 
the recipient may not require an LEP person to 
use a family member or friend as an inter-
preter. 
(D) The recipient evaluates whether the 
person the patient wishes to use as an inter-
preter is competent. If the recipient has reason 
to believe that the interpreter is not competent, 
the recipient provides the recipient’s own inter-
preter to protect the recipient from liability if 
the patient’s interpreter is later found not com-
petent. 
(E) If the recipient has reason to believe 
that there is a conflict of interest between the 
interpreter and patient, the recipient may not 
use the patient’s interpreter. 
(F) The recipient has the patient sign a 
waiver, witnessed by at least 1 individual not 
related to the patient, that includes the infor-
mation stated in subparagraphs (A) through 
(E) and is translated into the patient’s lan-
guage. 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00127
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
128 
(2) When a medical emergency exists and the 
delay directly associated with obtaining competent 
interpreter or translation services would jeopardize 
the health of the patient but only until a competent 
interpreter or translation service is available; how-
ever, nothing in this subsection shall exempt emer-
gency rooms or similar entities that regularly pro-
vide health care services in medical emergencies 
from having in place systems to provide competent 
interpreter and translation services without undue 
delay. 
SEC. 206. REPORT ON FEDERAL EFFORTS TO PROVIDE CUL-
TURALLY 
AND 
LINGUISTICALLY 
APPRO-
PRIATE HEALTH CARE SERVICES. 
(a) REPORT.—Not later than 1 year after the date 
of enactment of this Act and annually thereafter, the Sec-
retary of Health and Human Services shall enter into a 
contract with the Institute of Medicine for the preparation 
and publication of a report that describes Federal efforts 
to ensure that all individuals with limited-English pro-
ficiency have meaningful access culturally competent to 
health care and health-care-related services. Such report 
shall include— 
(1) a description and evaluation of the activities 
carried out under this Act; 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00128
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
129 
(2) a description and analysis of best practices, 
model programs, guidelines, and other effective 
strategies for providing access to culturally and lin-
guistically appropriate health care services; 
(3) recommendations on the development and 
implementation of policies and practices by providers 
of health care and health-care-related services for 
limited-English-proficient individuals; 
(4) a description of the effect of providing lan-
guage services on quality of health care and access 
to care; and 
(5) a description of the costs associated with or 
savings related to the provision of language services. 
(b) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as may be necessary for each of fiscal years 
2012 through 2016. 
SEC. 207. ENGLISH FOR SPEAKERS OF OTHER LANGUAGES. 
(a) GRANTS AUTHORIZED.—The Secretary of Edu-
cation is authorized to provide grants to eligible entities 
for the provision of English as a second language (here-
after referred to as ‘‘ESL’’) instruction and shall deter-
mine, after consultation with appropriate stakeholders, the 
mechanism for administering and distributing such 
grants. 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00129
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
130 
(b) ELIGIBLE ENTITY DEFINED.—For purposes of 
this section, the term ‘‘eligible entity’’ means a State or 
community-based organization that employs, and serves, 
minority populations. 
(c) APPLICATION.—An eligible entity may apply for 
a grant under this section by submitting such information 
as the Secretary may require and in such form and man-
ner as the Secretary may require. 
(d) USE OF GRANT.—As a condition of receiving a 
grant under this section, an eligible entity shall— 
(1) develop and implement a plan for assuring 
the availability of ESL instruction that effectively 
integrates information about the nature of the 
United States health care system, how to access 
care, and any special language skills that may be re-
quired for them to access and regularly negotiate the 
system effectively; 
(2) develop a plan, including, where appro-
priate, public-private partnerships, for making ESL 
instruction progressively available to all individuals 
seeking instruction; and 
(3) maintain current ESL instruction efforts by 
using the additional funds to supplement rather 
than supplant any funds expended for ESL instruc-
tion in the State as of January 1, 2006. 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00130
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
131 
(e) ADDITIONAL DUTIES OF THE SECRETARY.—The 
Secretary of Education shall— 
(1) collect and publicize annual data on how 
much Federal, State, and local governments spend 
on ESL instruction; 
(2) collect data from State and local govern-
ments to identify the unmet needs of English lan-
guage learners for appropriate ESL instruction, in-
cluding— 
(A) the preferred written and spoken lan-
guage of such English language learners; 
(B) the extent of waiting lists including 
how many programs maintain waiting lists and, 
for programs that do not have waiting lists, the 
reasons why not; 
(C) the availability of programs to geo-
graphically isolated communities; 
(D) the impact of course enrollment poli-
cies, including open enrollment, on the avail-
ability of ESL instruction; 
(E) the number individuals in the State 
and each participating locality; 
(F) the effectiveness of the instruction in 
meeting the needs of individuals receiving in-
struction and those needing instruction; 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00131
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
132 
(G) as assessment of the need for pro-
grams that integrate job training and ESL in-
struction, to assist individuals to obtain better 
jobs; and 
(H) the availability of ESL slots by State 
and locality; 
(3) determine the cost and most appropriate 
methods of making ESL instruction available to all 
English language learners seeking instruction; and 
(4) within 1 year of the date of enactment of 
this Act, issue a report to Congress that assesses the 
information collected in paragraphs (1), (2), and (3) 
and makes recommendations on steps that should be 
taken to progressively realize the goal of making 
ESL instruction available to all English language 
learners seeking instruction. 
(f) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to the Secretary of Edu-
cation for each of fiscal years 2012 through 2015 
$250,000,000 to carry out this section. 
SEC. 208. IMPLEMENTATION. 
(a) GENERAL PROVISIONS.— 
(1) A State shall not be immune under the 
Eleventh Amendment of the Constitution of the 
United States from suit in Federal court for failing 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00132
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
133 
to provide the language access funded pursuant to 
this title. 
(2) In a suit against a State for a violation of 
this title, remedies (including remedies at both at 
law and in equity) are available for such a violation 
to the same extent as such remedies are available for 
such a violation in the suit against any public or pri-
vate entity other than a State. 
(b) RULE OF CONSTRUCTION.—Nothing in this title 
shall be construed to limit otherwise existing obligations 
of recipients of Federal financial assistance under title VI 
of the Civil Rights Act of 1964 (42 U.S.C. 2000(d) et 
seq.) or any other statute. 
SEC. 209. LANGUAGE ACCESS SERVICES. 
(a) ESSENTIAL BENEFITS.—Section 1302(b)(1) of 
the Patient Protection and Affordable Care Act (42 
U.S.C. 18022(b)(1)) is amended by adding at the end the 
following: 
‘‘(K) Language access services, including 
oral interpretation and written translations.’’. 
(b) EMPLOYER-SPONSORED MINIMUM ESSENTIAL 
COVERAGE.—Section 36B(c)(2)(C) of the Internal Rev-
enue Code of 1986 is amended by adding at the end the 
following: 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00133
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
134 
‘‘(v) COVERAGE MUST INCLUDE LAN-
GUAGE ACCESS AND SERVICES.—Except as 
provided in clause (iii), an employee shall 
not be treated as eligible for minimum es-
sential coverage if such coverage consists 
of an eligible employer-sponsored plan (as 
defined in section 5000A(f)(2)) and the 
plan does not provide coverage for lan-
guage access services, including oral inter-
pretation and written translations.’’. 
(c) QUALITY REPORTING.—Section 2717(a)(1) of the 
Public Health Service Act (42 U.S.C. 300gg–17(a)(1)) is 
amended— 
(1) by striking ‘‘and’’ at the end of subpara-
graph (C); 
(2) by striking the period at the end of sub-
paragraph (D) and inserting ‘‘; and’’; and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(E) reduce health disparities through the 
provision of language access services, including 
oral interpretation and written translations.’’. 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00134
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS
141 
tute on Minority Health and Health Disparities, shall es-
tablish a technical clearinghouse on health workforce di-
versity within the Office of Minority Health and coordi-
nate current and future clearinghouses. 
‘‘(b) INFORMATION AND SERVICES.—The clearing-
house established under subsection (a) shall offer the fol-
lowing information and services: 
‘‘(1) Information on the importance of health 
workforce diversity. 
‘‘(2) Statistical information relating to under-
represented minority representation in health and al-
lied health professions and occupations. 
‘‘(3) Model health workforce diversity practices 
and programs. 
‘‘(4) Admissions policies that promote health 
workforce diversity and are in compliance with Fed-
eral and State laws. 
‘‘(5) Lists of scholarship, loan repayment, and 
loan cancellation grants as well as fellowship infor-
mation for underserved populations for health pro-
fessions schools. 
‘‘(6) Foundation and other large organizational 
initiatives relating to health workforce diversity. 
‘‘(c) CONSULTATION.—In carrying out this section, 
the Secretary shall consult with non-Federal entities which 
VerDate Mar 15 2010 
22:29 Sep 20, 2011
Jkt 099200
PO 00000
Frm 00141
Fmt 6652
Sfmt 6201
E:\BILLS\H2954.IH
H2954
emcdonald on DSK5VPTVN1PROD with BILLS