The eDeliveryNow® Platform is an open and modular framework that utilizes REST APIs and Web Services to make it extensible and adaptable to meet current and future customer communication needs.


AccessibilityNow provides high levels of automation and integration into any environment, the platform includes software solutions and a wide range of tailored services to meet the document accessibility needs of all organizations, large and small, private sector and governments of all levels.

CMS Final Rule Impacting Accessibility and Language Support

Veterans in digital accessibility can attest that mandates arrive like crashing waves. The most recent wave we see crashing ashore is the CMS Final Rule which compels Medicare Advantage and Part D Payors to meet new standards requiring communications to be:

  • In the foreign language of a given population
  • Accessible according to Section 508 – or in the case of documents, in an accessible, tagged PDF format
  • In alternate formats such as braille, large print and audio files

This mandate will transform how payors manage their communication strategies.  Let’s explore the impact on organizations and how they can address these requirements.

Language Translation

Under this new rule, healthcare communications such as enrollment kits, letters, Annual Notice of Change (ANOC), Evidence of Coverage (EOC), Explanation of Benefits (EOB) and Summary Benefits must be made available in foreign languages if the population speaking that language in a given state exceeds 5%.  Here is the challenge – creating complex communications in any additional foreign language can be complex and take months to develop within your communications composition system. And that’s for languages such as Spanish or French. Add in more challenging languages such as Mandarin, Vietnamese or even Russian, and the complexity goes way up. And you guessed it, the time to market and resources needed to develop accurate translations for these additional foreign languages goes way up too.

But what if you could use a process that allows you to handle translation to over 120 languages, be smart enough to account for cultural nuances, incorporate industry specific glossaries of terms, all while maintaining the fidelity of the original document? Tall order, right? Then add to that the need to do all of this in minutes or hours for volumes exceeding millions per month, and you start to glimpse the size of the challenge. Hold that thought though, because we still have to discuss accessibility.

Accessible Communications, or Section 508 Compliant Documents

The new CMS Final Rule highlights the requirement for accessibility with healthcare communications. Communications must be WCAG-compliant and accessible by assistive technology. This is not just a recommendation, but a base requirement ensuring all recipients have access to and can understand the information, regardless of their abilities.

Document Accessibility compliance requires creating accessible, tagged PDF documents.  These means content is structured and tagged for screen readers to navigate and that all text, table and images are interpretable.  Whether you manage this within your authoring function, or post-authoring or on-demand, the baseline is that payors are required to immediately present PDFs that can be read by assistive technology.  For payors managing high volumes of documents, this means scalable and efficient solutions that can produce compliant documents in real time.

Alternate Formats: Speed and Equality in Communication Delivery

Gone are the days when payors can get around to providing alternate formats in 2-4 weeks. The turnaround time requirement now is measured in hours that add up to less than one business day. This means that the braille, large print and audio files (on MP3 or DVD media) must be out the door, in the mail in hours – not days. And, if you think about it, this makes sense. Forcing someone who relies on these formats to wait weeks does indeed feel discriminatory. This accelerated delivery requirement is critical to ensure equity.

The creation of alternate formats is complex. For example, Braille requires specialized transcription to ensure the content is accurately represented. Large print involves reformatting documents while maintaining readability and layout integrity. Audio files must consist of clear, accurate narration that conveys all document details. Meeting these requirements within a tight window is challenging, but absolutely necessary for inclusivity.

Crawford Technologies: Your Partner in Navigating the New Landscape

So, back to the tall order. The reason Crawford Technologies exists – to help with situations exactly like this. We help payors and other large companies deliver information in the formats and through the channels that our clients’ customers demand. By using cost-effective, advanced workflows and state of the art technology, we can help implement applications that instantly translate repetitive document content into over 120 languages, account for all the cultural and industry-specific terms, maintain fidelity AND, at the same time generate that content in accessible formats, whether that be accessible PDF, Braille, large print or audio.

Interested in learning more about the CMS Final Rule? Watch our recent webinar, Elevate Healthcare Accessibility: Revealing Compliance with the CMS Final Rule., where we discuss the challenges that our payor customers are facing and how CrawfordTech’s AccessibilityNow® Translate solution can help you automate and streamline it all.

Now is the Time to Embrace the Future of Accessible Communications

Accessible translations and formats are no longer optional—they are essential for inclusive and equal healthcare delivery. With so much changing in healthcare communications, Crawford Technologies is here to help you navigate these mandates and communicate effectively with all your customers.

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June 15, 2024


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