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DHCF Announces Implementation of New Medicaid Managed Care Health Plans

Friday, October 2, 2020

(WASHINGTON, DC) – The Department of Health Care Finance (DHCF) announces the implementation of new managed care contracts, which will set the foundation to expand access to care and improve health outcomes for District residents. DHCF and the new managed care plans – AmeriHealth Caritas DC, MedStar Family Choice DC, and CareFirst Community Health Plan DC (formerly known as Trusted Health Plan) – have worked together in preparation for this milestone in the District’s Medicaid reform efforts. During this readiness phase, we conducted systems testing, virtual managed care organization (MCO) site visits, continuity of care activities, provider and beneficiary outreach, and townhall events to ensure that MCOs were prepared for this transition and beneficiaries were informed about their plan and the services available to them.

As we conclude the readiness phase and officially start the 90-day transition period, which began on October 1, 2020 and extends through December 31, 2020, continuity of care for enrollees is the priority. We are undertaking several steps to ensure that beneficiaries continue to have access to their medical care, prescriptions, and case management.

To minimize interruptions to care or access to prescriptions, all active referrals and authorizations for services and supplies issued prior to October 1, 2020 will remain valid through December 31, 2020. In addition, each MCO will reach out to its new members to conduct a Health Risk Assessment, and those with special health care needs will be contacted by a nurse to receive a comprehensive assessment and individualized care plan. All enrollees who are dissatisfied with their auto-assigned plan may switch plans at any time during the transition phase.

“DHCF is excited to be on the path of reform to realize our vision that all residents in the District have the supports and services they need to be actively engaged in their health and to thrive,” said Medicaid Director Melisa Byrd. “Our top priority during this transition period is ensuring that enrollees understand the benefits available to them and continue to have access to the care and services they need.”

The Department of Health Care Finance is the District of Columbia’s State Medicaid Agency.