For the purposes of this chapter, the term:
(1) "Attorney General" means the Attorney General for the District of Columbia.
(2) "CMPA" means Chapter 6 of Title 1.
(3) "Department" means the Department of Health Care Finance established by § 7-771.02.
(4) "Department CFO" means the Chief Financial Officer for the Department of Health Care Finance.
(5) "District CFO" means the Chief Financial Officer of the District of Columbia.
(6) "DOH" means the Department of Health.
(7) "MAA" means the Medical Assistance Administration.
(8) "PPA" means Unit A of Chapter 3 of Title 2.
(Feb. 27, 2008, D.C. Law 17-109, § 2, 55 DCR 216.)
HISTORICAL AND STATUTORY NOTES
Legislative History of Laws
Law 17-109, the "Department of Health Care Finance Establishment Act of 2007", was introduced in Council and assigned Bill No. 17-76 which was referred to the Committee on Health. The Bill was adopted on first and second readings on November 6, 2007, and December 11, 2007, respectively. Signed by the Mayor on December 27, 2007, it was assigned Act No. 17-227 and transmitted to both Houses of Congress for its review. D.C. Law 17-109 became effective on February 27, 2008.
Miscellaneous Notes
Section 7090 of D.C. Law 17-219 repealed section 13 of D.C. Law 17-109.
Pursuant to § 1-204.04(b), there is established a Department of Health Care Finance as a separate, cabinet-level agency, subordinate to the Mayor, within the executive branch of the government of the District of Columbia.
(Feb. 27, 2008, D.C. Law 17-109, § 3, 55 DCR 216.)
HISTORICAL AND STATUTORY NOTES
Emergency Act Amendments
For temporary (90 day) addition of section, see § 5014 of Fiscal Year 2013 Budget Support Emergency Act of 2012 (D.C. Act 19-383, June 19, 2012, 59 DCR 7764).
For temporary (90 day) addition of section, see § 5014 of Fiscal Year 2013 Budget Support Congressional Review Emergency Act of 2012 (D.C. Act 19-413, July 25, 2012, 59 DCR 9290).
Legislative History of Laws
For Law 17-109, see notes following § 7-771.01.
Miscellaneous Notes
For Department of Health Care Finance reporting requirements to Council, see § 5014 of D.C. Law 19-168.
The Department shall:
(1) Maximize the well-being and quality of life for eligible low-income individuals and other populations through the provision of leadership and direction in administering responsive, effective, and efficient health-care benefits;
(2) Develop a comprehensive, efficient, and cost-effective health-care system for the District's uninsured, under-insured, and low-income residents;
(3) Develop eligibility, service coverage, and service delivery and reimbursement policies for the District's health-care-financing programs that ensure improved access and efficient delivery of service;
(4) Ensure that District health-care programs maximize available federal financial assistance; and
(5) Support the health-care policy, delivery, and access initiatives of the Department of Health and other District agencies through sound health-care financing.
(Feb. 27, 2008, D.C. Law 17-109, § 4, 55 DCR 216.)
HISTORICAL AND STATUTORY NOTES
Legislative History of Laws
For Law 17-109, see notes following § 7-771.01.
The Department shall be headed by a Director, who shall:
(1) Be appointed by the Mayor with the advice and consent of the Council, pursuant to § 1-523.01(a);
(2) Be qualified by experience and training to carry out the purposes of the Department as set forth in § 7-771.03; and
(3) Serve at the pleasure of the Mayor.
(Feb. 27, 2008, D.C. Law 17-109, § 5, 55 DCR 216.)
HISTORICAL AND STATUTORY NOTES
Legislative History of Laws
For Law 17-109, see notes following § 7-771.01.
In addition to other duties as may be lawfully imposed, the Director shall:
(1) Supervise and direct the Department, organizing the Department for its efficient operation, including creating offices within the Department, as necessary, and exercising any other powers necessary and appropriate to implement the provisions of this chapter;
(2) Receive, manage, and disburse all local and federal funds for operations and medical-assistance purposes of the Department;
(3) Exercise personnel authority as appropriate to perform the functions of the Department consistent with Chapter 6 of Title 1;
(4) Execute grants, contracts, memoranda of agreement and understanding, or other agreements with governmental bodies, public and private agencies, institutions, and organizations on behalf of the Department;
(5) Collaborate with other District agencies to ensure the coordination of Department initiatives that may affect or involve programs within other District agencies; and
(6) Promulgate and implement rules and regulations necessary and appropriate to accomplish his or her duties and the Department's functions in accordance with subchapter I of Chapter 5 of Title 2.
(Feb. 27, 2008, D.C. Law 17-109, § 6, 55 DCR 216.)
HISTORICAL AND STATUTORY NOTES
Legislative History of Laws
For Law 17-109, see notes following § 7-771.01.
The Department shall:
(1) Have a Chief Financial Officer separate from any financial cluster, who shall:
(A) Be appointed by the Chief Financial Officer of the District of Columbia after consultation with the Director;
(B) Be qualified by experience and training to carry out accounting, budgeting, and financial management functions;
(C) Report directly to, be ultimately responsible to, and be under the supervisory direction of the District CFO, through the Director;
(D) Engage in the accounting, budgeting, and financial management functions as authorized by the District CFO;
(E) Serve as a member of the Department management team;
(F) Advocate for and advance the policy objectives of the Director, to the extent consistent with the ultimate responsibility of the Department CFO to, and supervisory control by, the District CFO; and
(G) Be subject to evaluation, discipline, and transfer by the District CFO, in consultation with the Director;
(2) Have a general counsel or the equivalent, who shall:
(A) Be appointed by the Attorney General for the District of Columbia as an employee of the Office of the Attorney General, after consultation with the Director;
(B) Be an attorney admitted to the practice of law in the District of Columbia;
(C) Be qualified by experience and training to advise the Department with respect to legal issues related to its powers and duties;
(D) Be in the Senior Executive Attorney Service as an at-will employee under the direction and control of the Attorney General;
(E) Be subject to all applicable provisions of subchapter VIII-B of Chapter 6 of Title 1;
(F) Have an attorney-client relationship with the Department;
(G) Advocate vigorously for the positions of the Department on legal issues, and if that advocacy poses a conflict with a legal position of the Attorney General, seek exemption from the supervision of the Attorney General as to that position, in accordance with § 1-608.55(b); and
(H) Be subject to evaluation, discipline, and transfer by the Attorney General, after consultation with the Director; and
(3) Have sufficient staff, supervisory personnel, and resources, and be organized to carry out the functions and duties set forth in this chapter.
(Feb. 27, 2008, D.C. Law 17-109, § 7, 55 DCR 216.)
HISTORICAL AND STATUTORY NOTES
Legislative History of Laws
For Law 17-109, see notes following § 7-771.01.
Notwithstanding any other provision of law, the Department shall:
(1) Be the single state agency, successor to the Medical Assistance Administration, for the administration of the Medicaid Program under section 1902(a)(5) of the Social Security Act, approved July 30, 1965 (79 Stat. 344; 42 U.S.C. § 1396a(a)(5));
(2) Administer the D.C. HealthCare Alliance program and any other publicly funded health-care insurance program;
(3) Coordinate with the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services on all waivers, State Plan amendments, demonstration grants, and other opportunities to maximize federal assistance and fulfill the purposes of the Department as set forth in § 7- 771.03;
(4) Coordinate with other District government agencies to ensure effective and efficient use of Medicaid dollars, including providing training and technical assistance to ensure proper and timely billing and claims processing;
(5) Cooperate with other District agencies to ensure coordinated health-care access and delivery for publicly funded health-care services;
(6) Collaborate with the District agency responsible for eligibility determination in monitoring enrollment and beneficiary-outreach efforts;
(7) Engage providers and clients in eligibility, access, quality-of-care, and reimbursement issues;
(8) Develop and maintain a comprehensive information-technology infrastructure that accurately and efficiently processes claims, interfaces with other necessary public, private, and nonprofit information-technology systems, and collects information for data analysis of trending, cost measurement, performance management, policy development, and strategic planning;
(9) Develop a long-term-care-finance infrastructure, in cooperation with other District agencies, including the Department of Disability Services, Office on Aging, Long-Term Care Ombudsman, and DOH;
(10) Promote cost-containment initiatives through policy development, best-practice implementation, grant development, innovative strategies to leverage funding sources, and strategic planning;
(11) Develop an annual budget for the Department to be submitted to the Council by the Mayor, in accordance with § 1-204.42; and
(12) Exercise any other power or duty necessary to fulfill the purposes of the Department as set forth in § 7-771.03.
(Feb. 27, 2008, D.C. Law 17-109, § 8, 55 DCR 216.)
HISTORICAL AND STATUTORY NOTES
Legislative History of Laws
For Law 17-109, see notes following § 7-771.01.
Effective until October 1, 2009, the Department shall exercise:
(1) Personnel authority to hire, retain, and terminate personnel as appropriate to perform the functions of the Department consistent with Chapter 6 of Title 1, including establishing compensation and reimbursement consistent with the District's wage grade and non-wage grade schedules and the Congressionally approved budget; and
(2) Procurement authority independent of the Office of Contracting and Procurement, consistent with Chapter 3A of Title 2; except, that § 2- 352.01(a) shall not apply.
(Feb. 27, 2008, D.C. Law 17-109, § 9, 55 DCR 216; Sept. 26, 2012, D.C. Law 19-171, § 209, 59 DCR 6190.)
HISTORICAL AND STATUTORY NOTES
Effect of Amendments
D.C. Law 19-171, in par. (2), substituted "consistent with Chapter 3A of Title 2; except, that § 2-352.01(a) shall not apply" for "consistent with unit A of Chapter 3 of Title 2; except with regard to the powers and duties set forth in § 2-301.05(a), (b), (c), and (e)".
Legislative History of Laws
For Law 17-109, see notes following § 7-771.01.
For history of Law 19-171, see notes under § 7-242.
(a) No later than March 1, 2008, the Mayor shall submit a proposed transition plan, which has been approved by the Chief Financial Officer and which is accompanied by a proposed resolution, to the Council for a 45-day period of review, excluding Saturdays, Sundays, legal holidays, and days of Council recess, that identifies:
(1) All the powers, duties, functions, operations, real and personal property, positions, assets, records, and obligations, and all unexpended balances of appropriations, allocations, and other funds available, or to be made available, including those from the MAA and the Health Care Safety Net Administration, that are used to accomplish the purposes of the Department as set forth in § 7-771.03;
(2) The powers, duties, functions, operations, real and personal property, positions, assets, records, and obligations, and all unexpended balances of appropriations, allocations, and other funds available, or to be made available, that will be transferred to the Department;
(3) The impact of the proposed transfers on the budget of DOH and on the budgets of each affected District agency;
(4) The personnel who shall form the transition team and who shall be accountable for the monitoring and allocation of functions and assets to be transferred to the Department; and
(5) The procedure by which other District government agencies shall pre-approve claims and allow providers to submit bills directly to the Department, enabling the Department to satisfy valid claims from all available funding sources.
(b) If the Council does not approve or disapprove the proposed transition plan, in whole or in part, by resolution within the 45-day review period, the proposed transition plan shall be deemed approved;
(c) Nothing in this section shall affect any requirements imposed upon the Mayor by subchapter I of Unit A of Chapter 3 of Title 2.
(Feb. 27, 2008, D.C. Law 17-109, § 10, 55 DCR 216.)
HISTORICAL AND STATUTORY NOTES
Legislative History of Laws
For Law 17-109, see notes following § 7-771.01.
No later than October 1, 2008, the transition plan required by § 7-771.09, as approved, shall be implemented.
(Feb. 27, 2008, D.C. Law 17-109, § 11, 55 DCR 216.)
HISTORICAL AND STATUTORY NOTES
Legislative History of Laws
For Law 17-109, see notes following § 7-771.01.
All rulemaking and regulations for the administration of the District Medicaid Program and D.C. Health Care Alliance Program, issued under appropriate authority, shall continue in full force and effect.
(Feb. 27, 2008, D.C. Law 17-109, § 12, 55 DCR 216.)
HISTORICAL AND STATUTORY NOTES
Legislative History of Laws
For Law 17-109, see notes following § 7-771.01.
