Multi-Language Insert Must Be Provided to Medicare Beneficiaries as of January 1, 2023

After reading this article you should understand what a multi-language insert is, why it must be provided, and when you are required to hand it out.

What is a multi-language insert (MLI)?

You have likely seen a MLI if you have received any written communication from your health plan. The document will offer free interpreter services along with a phone number to call to ask questions about your health or drug plan.

Specific details about what a MLI must contain can be found in 42 CFR § 423.2267(e)(33), “This is a standardized communications material which states, ‘We have free interpreter services to answer any questions you may have about our health or drug plan. To get an interpreter, just call us at [1-xxx-xxx-xxxx]. Someone who speaks [language] can help you. This is a free service.’ in the following languages: Spanish, Chinese, Tagalog, French, Vietnamese, German, Korean, Russian, Arabic, Italian, Portuguese, French Creole, Polish, Hindi, and Japanese.”

Why must a multi-language insert be provided?

Notification of this requirement was published on May 9, 2022 in the Federal Register, 87 FR 27704. According to the notice, 12.2 percent of persons aged 65 and older speak a language other than English in their home. The multi-language insert is meant to inform individuals that free interpreter services are available to them. This helps ensure that all patients are provided equal access to care across all patient populations. For more information about providing equal access, contact PAAS National® at (608) 873-1342 to learn more about our Cultural Competency and Linguistically Appropriate Services using the PAAS CARE Model.

When must a multi-language insert be handed out?

According to 87 FR 27704, the insert must be handed out “whenever a Medicare beneficiary is provided a CMS required material.” Lists of CMS-required materials can be found under 42 CFR§ 422.2267(e) and 42 CFR § 423.2267(e). Pharmacies would be directly impacted by 42 CFR § 423.2267(e)(21) – “Medicare Prescription Drug Coverage and Your Rights. This is a standardized communications material used to convey a beneficiary’s appeal rights when a drug cannot be filled at point-of-sale.” Since pharmacies are required to hand out the Medicare Prescription Drug Coverage and Your Rights form (CMS 10147), a CMS-required document, the MLI must be provided concurrently.

PAAS Tips:

Become an audit assistance member today to continue reading this article. As a member, you’ll have access to hundreds of articles and receive our monthly proactive newsletter!

Join today!

  • Auditors often confirm pharmacies are distributing the current version of CMS 10147 to Medicare beneficiaries, as required, and now they may look for the MLI as well (Elixir has explicitly stated that they will review this during onsite audits)
  • There is no requirement for pharmacies to document the distribution of the MLI
  • The phone number on each MLI is PBM-specific; if a MLI is not automatically generated by your software system with a populated phone number, we suggest utilizing the numbers below (TTY numbers are for people who have hearing loss or speech impairment which makes using a regular telephone difficult; conversations are typed instead of vocalized):
  • For additional details regarding MLI, refer to 42 CFR§ 422.2267(e) and 42 CFR § 423.2267(e)

Sara Hathaway, PharmD
Latest posts by Sara Hathaway, PharmD (see all)