Sorry, you need to enable JavaScript to visit this website.

dhcf

Department of Health Care Finance - DHCF
 

DC Agency Top Menu

Public Notice: Due to the MMIS conversion the last provider payment from Conduent was issued on February 27. There will be no payment issued on March 6, and the first post‑conversion payment will be issued on March 13. For more information visit https://medicaid.dc.gov/

-A +A
Bookmark and Share

Transmittal 21-13 PrEP and PEP Coverage for Medicaid Beneficiaries Enrolled in MCOs


Thursday, March 18, 2021

This is to inform you that the DC Department of Health Care Finance (DHCF) is implementing a policy change that will carve-out coverage and reimbursement for medications approved for HIV pre-exposure prophylaxis (PrEP) and for HIV post-exposure prophylaxis (PEP) from the Medicaid managed care program. The managed care organizations (MCOs) will no longer reimburse for these medications through the DC Healthy Families Program (DCHFP). This policy does not apply to individuals enrolled in the DC Healthcare Alliance (Alliance) or the Immigrant Children’s Program (ICP).