For Medicaid MCOs and state agencies
Renewal notices people can read in their own language
During the unwinding, 69% of Medicaid disenrollments were for procedural reasons, such as paperwork. Work requirements and 6-month renewals start on January 1, 2027, unless HHS gives your state more time for work requirements, so more notices go out, more often. A clear notice helps people act in time. We make notices clear in English and Spanish, and can put them into 45 languages and regional variants.
Send a blank template, not a copy with a patient's or member's details.
HealthcareGPS is SOC 2 Type II audited and HIPAA compliant. How we protect your documents
Jan 1, 2027
Medicaid work requirements and 6-month renewals start for expansion adults, unless HHS gives a state more time for work requirements. States must reach enrolled adults before then.
Source: CMS, community engagement interim final rule fact sheet (2026-06-01)
What we fix
A renewal notice in English and Spanish
- The date and what to send come first in both versions.
- Dates, amounts and "do not" rules are compared between them.
- A trained reviewer checks the Spanish of a key document before release.
Illustrative example.
Paperwork is the main reason people lose coverage
During the Medicaid unwinding, 69% of disenrollments were for procedural reasons, such as forms not returned. Most of those people did not choose to leave. A clear notice can help them stay.
Source: KFF, Medicaid Enrollment and Unwinding Tracker (data through 2024).
How a translated notice gets to release
Every translated notice goes through the same steps. If a date, an amount or a "do not" could be lost, a person translates it.
Step 1: Translate
Into 45 languages and regional variants, with your glossary and protected terms.
Step 2: Clinical anchor gate
Each segment with a date, an amount, a dose or a "do not" is checked before it moves on.
If the gate flags a segment: human hand-off
The segment goes to a human translator instead of being guessed.
Step 3: Integrity checks
Numbers, negation, order and links are compared across languages.
Step 4: Back-translation
A reviewer reads the result back in English.
Step 5: Reviewer approval
A qualified reviewer approves the exact text. The approval is voided if the source changes.
Step 6: Release
A machine draft of a key document can't go out until a person reviews it.
Spanish is measured as Spanish
English formulas give wrong scores for Spanish text. So we use Spanish readability measures. These include SOL, with an INFLESZ floor, and Fernández-Huerta. Targets are set against MedlinePlus en español. Pick US, Puerto Rico, Mexico or Spain Spanish, and usted or tú.
Language Access Assurance
- Mark your key documents. A machine draft of one can't go out until a person reviews it.
- Name trained reviewers, or send work to your language vendor.
- Keep a signed record for every reviewed translation.
- Use the §1557 notice of availability (45 CFR 92.11) kit and the 5% threshold calculator.
Machine translation: safe in some languages, risky in others
A 2025 study checked machine-translated discharge papers. In Spanish, errors that could cause harm were as rare as with a professional translator. In Somali, 92% of sections had them.
So we set risk by language. Critical text in languages other than Spanish goes to a qualified person by default. State laws add languages, too. New York requires 12 for state agencies. New Jersey requires 7 and a written plan.
Errors that could cause harm
| Language | Machine | Professional |
|---|---|---|
| Spanish | 7% | 7% |
| Vietnamese | 41% | 14% |
| Chinese | 52% | 20% |
| Somali | 92% | 13% |
Source: Brewster et al., JAMA Network Open, 2025-09-17; New York Executive Law §202-a; New Jersey Language Access Law (NJ Department of Human Services).
What a work-requirement notice must say, before January 2027
- Who must meet the rule, and who is exempt.
- How to meet it, and how to report hours.
- What happens if they don't.
- Which past months count (the look-back period).
- How to ask for a hearing.
Notices must be plain and work for people with limited English or a disability. They go out in at least two ways, such as mail and text. We check every notice against this list.
Source: Public Law 119-21 (2025); CMS interim final rule on Medicaid community engagement (2026-06-01).
Prove it on your own members
Split your next renewal reminder or outreach mailing. Half your members get today's reminder, half get the version your reviewers approved. Same timing, language and channels.
Before it starts, you pick the measure (renewals completed on time, from the enrollment files your state sends) and write the rule that decides, such as "expand if the revised group does better and the 95% interval excludes zero." No lift is promised. Your data decides, not ours.
We work from templates only. Your members' data stays with you.
Dates that set the calendar
- 2027-01-01
- Work requirements and 6-month renewals begin (CMS-2454-IFC), unless HHS gives your state more time for work requirements.
- 2027-04-26
- ADA Title II for state agencies and large public entities.
- 2027-07-09
- Access-rule secret-shopper reviews, incl. translation and taglines.
- By 2028-12-31
- Medicaid managed-care Quality Rating System goes live.
ADA Title II and HHS §504 dates verified 2026-10-08 against the Federal Register: DOJ interim final rule, 91 FR 20902 (2026-04-20); HHS interim final rule, FR doc 2026-09266 (2026-05-11), 45 CFR 84.84(b). Both keep WCAG 2.1 AA.
How accessibility review worksIn their words
What people using it say
…sent exactly what you sent us to our privacy legal team for review and approval and they had no notes. … the tool knocked it out of the park on the first try.
Director of communications, regional health plan I'm impressed with this tool and I think it'll help us a lot to improve our outreach with our members.
Director of customer experience, Medicare Advantage plan
From people using HealthLiteracyCopilot, shared anonymously by role and type of organization. Trimmed where marked (…), never reworded.
Built for each role on your team
What each person is measured on, the documents they own and the parts of the platform they'd use most.
- Member communicationsFewer review rounds. Every change explainedFor directors of member communications at health plansOn-time AEP mailingsReview cycles per documentMember complaints Read more
- Compliance and language accessShow the reviewer which criteria, which version, who approvedFor compliance officers and language-access leadsAudit findings§1557 and §438.10 conformanceComplaints to Medicare (CTMs) Read more
- Utilization managementA specific denial reason is required now. Make it one the member can followFor VPs of utilization management, prior authorization and appeals at health plansCMS-0057-F complianceAppeal volumeOverturn rate Read more
- Medicaid eligibility communicationsRenewal notices that put the action and the deadline firstFor eligibility and renewal communications leads at state Medicaid agenciesProcedural disenrollmentsNotices reviewed before each mailingRequired notice content Read more
The Notice & Letter Kit
Start from Medicaid letter packs in English, US Spanish and Puerto Rico Spanish. The kit has renewal letters and approval-before-care letters. It adds the §1557 notice of availability (45 CFR 92.11). It adds Medicaid taglines, too (42 CFR 438.10). It also watches for rule changes, so you know which letters to update.
Send a blank template, not a copy with a patient's or member's details.
HealthcareGPS is SOC 2 Type II audited and HIPAA compliant. How we protect your documents
Questions
What reading level should Medicaid member materials be written at?
Federal rule 42 CFR 438.10 requires materials to be "easily understood" and lets states set the level. California uses 6th grade, Minnesota 7th, and New York sets 4th to 6th for some denial notices.
Does machine-translated Spanish satisfy Section 1557?
Not on its own. 45 CFR 92.201(c)(3) requires a qualified human translator to review machine translation of critical text. HealthLiteracyCopilot measures Spanish with Spanish readability measures and routes changes to your reviewers. It supports that review and doesn't replace it.
Do you need member PHI?
No. A review uses your template library: blank or sample notices. No member data is needed.