To be eligible for dc medicaid, you must be a resident of the district of columbia and must. See the frequently asked questions about medicaid renewals pdf. Health insurance counseling project hicp fact sheet pdf district of columbia longterm care waiver medicaid application 2018 retroactive medicaid application for institutional care 2018. The medicaid program is jointly funded by the federal government and states. Amerihealth caritas dc is contracted to provide covered services for enrollees of the medicaid and alliance programs in all eight district wards. The district of columbia administers a generous medicaid program for lowincome and medically needy residents. As of august 2015, 19 states have 26 approved medicaid health home models in operation. Medicaid reimbursement to eligible providers of emergency medical ground. Department of health care finance dhcf washington d. Medicaid managed care plans to provide health insurance and services. Dc healthy families is a medicaid program under the. Please see section 15 of the dc medicaid provider manual for more information about requesting a reconsideration. Applicants of trusted health plan, district of columbia who are not actively enrolled with dc medicaid and are required to enroll must ensure enrollment occurs. Also, you may be eligible if you are pregnant or have children.
Available resources and support for dc children and. Both facilities are open seven 7 days a week from 8am8pm and offer testing for covid19 if indicated with a doctors order. Medicaid also provides coverage of services in varied programs home. Medicaid also provides coverage of services in varied programs home and community based waiver programs, epsdt, etc. Nov 23, 2015 dc medicaid prior authorization number. Medicaid serves as a health care plan that offers coverage for doctor visits, hospitalization, eye care, dental, durable medical equipment, transportation and other related medical services. Jun 22, 2016 the department of health care finance provides health care services to lowincome children, adults, the elderly, and persons with disabilities. Department of health care finance dc medicaid alliance and me. Rehabilitation services mhrs among dc medicaid beneficiariespdf. Department of health care finance dhcf february 19 at 12.
District of columbia medicaid nursing home eligibility. See the frequently asked questions about medicaid renewals pdf there are now three 3 different applications and different ways to apply for medical. Officials of the districts healthcare finance agency offered a similar explanation and said that after nov 1. Long term care program medical assistance application. If you have questions, please call member services at 18004087511 medicaid or 18668422810 alliance. Dc healthy families is a program of the dc department of health care finance that provides free health insurance for district residents and their.
For long term care services and supports this completed form must be uploaded to dc care connect or faxed to liberty healthcare corporation at 2026982075. Over 200,000 district of olumbia residents nearly one third of all residents receive health care services through dhfs medicaid and alliance programs. The cost of health insurance shouldnt be a barrier to getting covered. About 242,000 residentsmore than onethird of dc residentsreceive health care through medicaid. A foster care enrollee who decides to remain in this program. About one in three dc residents is covered by medicaid. The aca replaces almost all of the former eligibility rules with financial. Dc department of health care finance dhcf state medicaid plan fee for service. Department of health care finance and shall be periodically reenrolled in accordance with 42.
Pregnant women and children may apply for medical assistance at sites other than the county department of social services. Dhcfrequest for hearing in department of health care finance sunday, march 29, 2020 you may file the appeal online, inperson, by mail, or by calling the office of administrative hearings at 202 4429094. Health services for children with special needs, inc. To be eligible for dc medicaid, you must be a resident of the district of columbia and must meet nonfinancial and financial eligibility requirements. Program eligibility the district of columbia administers dchfp or medicaid, which includes the childrens health insurance program.
Provider manual district of columbia department of health. The district of columbia offers medical coverage to income eligible residents through medicaid, alliance and dc healthy families programs. If you are 65 or older or disabled, you may be eligible. Upon determination of your eligibility, you may qualify for managed care, feeforservice or a. Eligibility determination and enrollment process for epd waiver. We focus on young people with special health care needs. Dhcfrequest for hearing in department of health care finance sunday, march 29, 2020 you may file the appeal online, inperson, by mail, or by calling the. In the district of columbia, you may be eligible for dc healthy families benefits through amerigroup if you are.
A project funded by the dc department of health care finance in collaboration with the. The dc department of human resources dchr manages employee compensation and benefit programs that enable the district to attract, support, and retain a wellqualified and diverse workforce. Amerihealth caritas dc offers two products in the district, a medicaid product for. Policy, health care policy and research administration, department of health care finance, gave the update implementing aca medicaid changes see slides created and submitted the district of columbia verification plan which outlines the policy and procedures used to verify eligibility beginning october 1, 20. Cavella bishop, rn, mba, cphm program manager clinician, pharmacy and acute provider service 202 7248936 cavella. Department of health care finance dc medicaid alliance.
District of columbia medicaid is a joint federalstate health insurance program that provides health care coverage to lowincome and disabled adults, children and families. The department of health care finance dhcf, an agency established in fy 2009, provides health care services to lowincome children, adults, the elderly and persons with disabilities. Please contact the department of health care finance at 1877 632. Over 200,000 district of columbia residents onethird of all. Medicaid pays for the cost of nursing home care in district of columbia that meet certain financial and health criteria.
A childless adult up to age 64 who meets certain income requirements. These include such things as assistance with bathing, personal hygiene, dressing, meal preparation, grocery shopping, cleaning, laundry, assisting with physical exercises, and helping you get to and from doctors appointments, your job, and social activities. Medicaid and other public medical assistance programs in the. You can also submit a paper application which you can find on the state website, or get assistance applying here via an attroeny. A child may have dc medicaid under tefrakatie beckett and other health. Use the links below to download the fee schedule in your desired file format. Thats why the affordable care act streamlined the application process to help individuals and families apply for medicaid, or for financial assistance with private insurance costs. More information about these programs can be found on the dc department of health care finance website. Sep 27, 20 officials of the districts healthcare finance agency offered a similar explanation and said that after nov 1. Under the affordable care act section 2703, the health home state plan option allows states to design health homes to specifically provide comprehensive care coordination and disease management for medicaid beneficiaries with chronic conditions. Medicaid pays the medical bills of certain people who have low incomes. If dhcf or its contractors deny specific medical services to persons receiving medicaid or healthcare alliance benefits, that decision may be appealed to the office of administrative hearings. The department of health care finance dhcf is the state medicaid agency for the district of columbia and also administers the healthcare alliance program.
States can establish their own medicaid provider payment rates within federal requirements, and generally pay for services through feeforservice or managed care arrangements. Skilled nursing facility care hospice care home health care. Medicaid and spenddown eligibility what is medicaid. Clinic billing manual fqhc billing manual dbh feeforservice billing manual terms of usage. Role of department of health care finance dhcf the department of health are finance dhf is the district of olumbias state medicaid agency. You can submit a medicaid application online by clicking here. Dc implemented medicaid expansion through the affordable care act aca, and dc medicaid covers children, pregnant women, parents, and other adults at higher income levels than the thresholds applied in most states. Over 200,000 district of columbia residents onethird of all residents receive health care services through dhcfs medicaid and alliance programs. Listed below are training materials that are used to educate a provider about medicaid.
Dchr is committed to providing you with a high level of customer care in administering your district government employee benefits. Mar 01, 2018 the district of columbia administers a generous medicaid program for lowincome and medically needy residents. After you submit your application, it can take up to 45 days or 60 days if you are disabled for you to hear whether you have been approved for enrollment into the medicaid program. To do this, we must empower patients to work with their doctors and make health care decisions that are best for them. This means giving them meaningful information about quality and costs to be active health care consumers. That way, we can give your child the kind of attention and level of care that helps make his or her life. Services from doctors and other health care providers outpatient care home health care durable medical equipment like wheelchairs, walkers, hospital beds, and other equipment. Hospital billing codes and reimbursement rates for covid19 services. Over 250,000 district of columbia residents onethird of all residents receive health care services through dhcfs medicaid and alliance programs. Medicaid provider portal dc medicaid is a healthcare program that pays for medical services for qualified lowincome and disabled people. Healthcheck family brochure, healthcheck brochure for families english and spanish. Dhcf coronavirus covid19 related resources and guidance for providers, beneficiaries and dc residents who are seeking free health care coverage.
Colorado department of health care policy and financing. Jul 27, 2017 medicaid is administered by the department of health care finance dhcf and now accounts for 72 percent of the agencys budget. The department of health care finance, an agency that was established in fy 2009, provides health care services to lowincome children, adults, elderly, and persons with disabilities. The department of health care finance provides health care services to lowincome children, adults, the elderly, and persons with disabilities.
We pledge to put patients first in all of our programs medicaid, medicare, and the health insurance exchanges. Medicaid is administered by the department of health care finance dhcf and now accounts for 72 percent of the agencys budget. The federal government pays states for a specified percentage of program expenditures, called the federal medical assistance percentage fmap states must ensure they can fund their share of medicaid expenditures for the care and services available under their state plan. Updates to the laboratory billing codes and reimbursement rates for covid19 testing. Summary of services the department of health care finance provides health care services to lowincome children, adults, elderly and persons with disabilities. District of columbia, department of health care finance qualis. District of columbia, department of health care finance. Today, rather than searching pdfbased job aids, dhcf employees can find the. Medstar health also has two urgent care facilities in the district of columbia. Policy, health care policy and research administration, department of health care finance, gave the update implementing aca medicaid changes see slides created and submitted the district of columbia verification plan which outlines the policy and procedures used to. Clinic billing manual fqhc billing manual dbh feeforservice billing manual. This prescription order form pof is required by the district of columbia s department of health care finance dhcf to authorize medicaid funded long term care services and supports.
Temporary allowance of telephonic signature on long term care applications hha. Due to unexpected complications, medicaid and alliance provider payments will be delayed one business day to monday, feb. Regarding passive and manual renewal of medicaid enrollment, please provide. Department of health care finance organizational chart dhcf. The social security administration ssa holds fair hearings for medicaid eligibility decisions that are part of a supplemental security income ssi decision for low income, aged and blind and disabled individuals. Department of health care finance fy20122014 strategic plan for dhcf pdf.
Department of health care finance dhcf headquarters 441 4th street, nw, 900s, washington dc 20001 office hours monday to friday, 8. A guide to dental coverage for children in dc medicaid. Dhcfrequest for hearing in department of health care finance. Your medicare health benefits and services and prescription drug coverage as a member of medstar medicare choice dual advantage hmo snp this booklet gives you the details about your medicare and medicaid health care and prescription drug coverage from january 1 december 31, 2018. Program eligibility the district of columbia administers dchfp or medicaid, which. Eligibility amerigroup dc medicaid medicaid health plans. Personal care allows people to receive paid help with basic daily tasks in their home. Persons requesting medicaid only for family and childrens categories, including 1931 medicaid, need only to complete the application for colorado health care. The healthcheck training and resource center is for use by health professionals who see children under 21 years of age covered by medicaid in the district of columbia to serve as a selfdirected online learning experience. The mission of the dhcf is to improve health outcomes by providing access to comprehensive, costeffective and quality healthcare services for residents of the district of columbia. We focus on young people with special health care needs, providing your child with the attention and level of care that helps make their life as full as possible. Listed below are computer based training cbt programs that you may download and take at your leisure. To request specific training materials be available on the web portal, please call 202 9068319 inside dc metro area or 866 7529233 outside dc. Medstar also has 12 additional urgent care centers in the washington, dcbaltimore areas.
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