; (2) require navigators, certified application counselors, and other individuals assisting with enrollment to collect and report requests for language assistance; and (3) require the toll-free telephone hotlines established pursuant to section 1311(d)(4)(B) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18031(d)(4)(B) ) to submit an annual report documenting the number of language assistance requests, the types of languages requested, the range and average wait time for a consumer to speak with an interpreter, and any steps the hotline, and any entity contracting with the Secretary to provide language services, have taken to actively address some of the consumer complaints. (f) Effective date The amendments made by this section shall not apply to plans beginning prior to the date of the enactment of this Act. 214. Medically underserved populations Section 330(a) of the Public Health Service Act ( 42 U.S.C. 254b(a) ) is amended by adding at the end the following new paragraph: (3) Medically underserved The term medically underserved , with respect to a population, means— (A) the population of an urban or rural area designated by the Secretary as— (i) an area with a shortage of personal health services; or (ii) a population group having a shortage of such services