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DHCF Announces Historic Expanded Access to Care for Medicaid Beneficiaries in the District of Columbia

Wednesday, November 11, 2020

(WASHINGTON, DC) – Today, the DC Department of Health Care Finance (DHCF) announced that all Medicaid and Alliance enrollees in its managed care programs now have access to every acute care hospital in the District for both inpatient and outpatient hospital-based care. For the first time, agreements have been reached between each hospital and the three Medicaid managed care plans, ensuring program enrollees will enjoy uninterrupted access to care. This important new policy was made possible by new universal contracting requirements in the managed care contracts that became effective on October 1, 2020 and corresponding new provisions in DHCF’s Medicaid provider agreements.

Expanding access to care is one goal of DHCF’s Medicaid reform efforts over the next four years and we are thankful to the leadership of the following health plans and hospitals for supporting this effort:

  • AmeriHealth Caritas District of Columbia
  • MedStar Family Choice District of Columbia
  • Care First Community Health Plan District of Columbia
  • Children’s National Hospital
  • George Washington University Hospital
  • Howard University Hospital
  • Medstar Georgetown University Hospital
  • Medstar Washington Hospital Center
  • Sibley Memorial Hospital
  • United Medical Center

“The District is fortunate to have a strong hospital network that is equally committed to delivering quality care to persons with either private or publicly-funded health insurance, making possible this watershed policy,” said Deputy Mayor for Health and Human Services and Department of Health Care Finance Director Wayne Turnage.

“The partnerships established between the Medicaid managed care health plans and hospitals to expand access to care for Medicaid beneficiaries is a great step forward for the DC Medicaid program,” said Medicaid Director Melisa Byrd. “I look forward to the managed care plans and hospitals leveraging these partnerships to help improve the health outcomes for District residents.”

This transition, which is being implemented for more than 235,500 Medicaid and Alliance beneficiaries, commenced on October 1, 2020. The transition period continues through December 31, 2020. During this time, DHCF is working closely with managed care plans and various provider groups to ensure continuity of care for these members. DHCF will develop a comprehensive report on the transition process and its outcomes at the conclusion of this calendar year and anticipates issuing a final report to the DC Council’s Committee on Health in January 2021.

The Department of Health Care Finance is the District of Columbia’s State Medicaid Agency. For more information, visit dhcf.dc.gov.