32.1-330.2 - Medicaid managed care programs; program information documents; plain language required.

§ 32.1-330.2. Medicaid managed care programs; program information documents;plain language required.

A. Whenever medical assistance services pursuant to this chapter arefurnished through managed care programs, the Board of Medical AssistanceServices shall require that all program information documents furnishedrecipients covered thereunder shall be written in nontechnical, readilyunderstandable language, using words of common, everyday usage.

B. Each sponsor or administrator of any such managed care program shall testthe readability of its program information documents by use of the FleschReadability Formula, as set forth in Rudolf Flesch, The Art of ReadableWriting (1949, as revised 1974), and no program information document shall beused unless it achieves a Flesch total readability score of forty or more.The requirements of this subsection shall not apply to language which ismandated by federal or state laws, regulations or agencies.

C. All program information documents within the scope of this section, andall amendments thereto, shall be filed with the Department of MedicalAssistance Services in advance of their use and distribution, accompanied bycertificates setting forth the Flesch scores and certifying compliance withthe requirements of this section. Any program information document which isexempt from the requirements of subsection B shall be accompanied by adocumentation of the federal or state law, regulation or agency mandate thatauthorizes the exemption.

D. For the purpose of this section, the term "program informationdocuments" means all forms, brochures, handbooks or other documentation (i)provided recipients covered under Medicaid managed care programs, and (ii)describing the programs' medical care coverages and the rights andresponsibilities of recipients covered thereunder. Further, the term"recipient" shall include potential recipients and recipients.

(1996, c. 318.)