May 24, 2018
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National Pharmacy Benefit Manager to Strengthen How it Provides Language Assistance Services

National pharmacy benefit management company Medco will significantly
improve access to its services for limited English proficient members in
2009, the U.S. Department of Health and Human Services (HHS) announced

As the nation's largest mail-order pharmacy operation, Medco dispenses
more than one hundred million prescriptions a year through the mail.
Following an investigation of a complaint filed on behalf of a
Spanish-speaking member with HHS' Office for Civil Rights (OCR), Medco
developed a multi-faceted plan to improve services to non-English

"These actions will significantly improve members' ability to manage and
make informed decisions about their own health care -- a critical
objective under the federal law prohibiting discrimination based on
national origin," said Robinsue Frohboese, acting director of HHS'
Office for Civil Rights. "Industry action like this is needed to combat
health care disparities and promote health care reform to improve access
and delivery of quality health care for all. We hope and expect that
others in the industry will follow Medco's lead."

In 2009, Medco's efforts will focus first on the needs of
Spanish-speaking members. In addition to expanding its pool of
bilingual customer service representatives who speak Spanish, Medco will
revise its systems to enhance its ability to route Spanish-speaking
members who need help with prescription drug questions or problems
directly to bilingual staff, including pharmacists where possible and
appropriate. Medco will continue to use a telephonic interpreter
service available for more than 150 other languages to communicate with
other non-English speakers.

A critical improvement in Medco's internal computer systems will flag
language preference on an ongoing basis to aid effective communication
with limited English proficient persons during member-Medco contact.
Medco will work to implement this improved ability to identify and track
individuals' language preferences so that important written
communications and outbound telephone calls are placed to members in
their primary language. Medco will also review how best to notify
limited English proficient members that language assistance services are

Medco has committed to developing an evaluation process with respect to
interpreter competency. Staff at call centers and pharmacies expected
to communicate directly with members in languages other than English
will be assessed as to language proficiency, and those serving as
interpreters will be assessed for interpreting competency. Medco will
train all relevant staff on system changes intended to improve access to
limited English proficient members, and will monitor the results of
these efforts through periodic assessments. 

"Consistent with our commitment to making medicine smarter, we value
this opportunity to collaborate with HHS on initiatives that will help
empower patients with information to improve their understanding and use
of pharmacy benefits, and enable greater adherence to their physician's
prescribed therapy," said Glenn Taylor, Medco's group president of Key

Under Title VI of the Civil Rights Act of 1964 and its implementing
regulations, recipients of federal financial assistance are required to
take reasonable steps to provide meaningful access to their programs by
limited English proficient individuals who are eligible to receive their

A copy of Medco's written commitments and OCR's closure letter, along
with more information about OCR's enforcement of Title VI and other
federal civil rights laws, can be found at 

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