Revision: HCFA-PM-91-4 AUGUST 1991 (BPD) OMB No. 0938 Page 1 STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT MEDICAL ASSISTANCE PROGP~ State/Territory: District of Columbia Citation 42 CFR 430.10 As a condition for receipt of Federal funds under title XIX of'the Social Security Act, the DEPARTMENT OF HEALTH CARE FINANCE (Single State Agency) Submits the following State plan for the medical assistance program, and hereby agrees to administer the program in accordance with the provisions of this State plan, the requirements of titles XI and XIX of the Act, and all applicable Federal regulations and other official issuances of the Department.
Transcript
Revision: HCFA-PM-91-4AUGUST 1991
(BPD)
OMB No. 0938
Page 1
STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACTMEDICAL ASSISTANCE PROGP~
State/Territory: District of Columbia
Citation42 CFR430.10
As a condition for receipt of Federal fundsunder title XIX of' the Social Security Act,the
DEPARTMENT OF HEALTH CARE FINANCE
(Single State Agency)
Submits the following State plan for themedical assistance program, and herebyagrees to administer the program inaccordance with the provisions of this Stateplan, the requirements of titles XI and XIXof the Act, and all applicable Federalregulations and other official issuances ofthe Department.
Revision: HCFA-PM-91-4AUGUST 1991
(BPP)
OMB No. 0938
Page 2
STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACTMEDICAL ASSISTANCE PROGRAM
State/Territory: District of Columbia
Citation42 CFR431.10AT-79-29
1.1 Designat~on and Author~
(a) The DEPARTMENT OF HEALTH CARE FINANCE is the
single State agency designated to administeror supervise the administration of theMedicaid program under title XIX of theSocial Securi ty Act. (All references inthis plan to "the Medicaid agencyH mean theagency named in this paragraph) .
ATTACHMENT 1.1-A is a certification signedby the State Attorney General identifyingthe single state agency and citing the legalauthority under which it administers orsupervises administration of the program.
STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACTMEDICAL ASSISTANCE PROGRAM
State/Territory: District of Columbia
CitationSection1902 (a)of the Act
1.1 (tWhe State agency that administered orsupervised the administration of theplan approved under title X of the Actas of January 1, 1965, has beenseparately designated to administer orsupervise the administration of thatpart of this plan which relates to blindindividuals.
Yes. The State agency sodesignated is
This agency has a separate plan coveringthat portion of the State Plan undertitle XIX for which it is responsible.
X Not applicable. The entire planunder title XIX is administered or
supervised by the State agencynamed in paragraph 1.1(a).
TN No.Supersedes TN No.
Approval
Revision: HCFA-AT-80-38
MAY 22, 1980(BPP)
OMB No. 0938
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STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT
MEDICAL ASSISTANCE PROGRAM
State/Territory: District of Columbia
Citation 1.1(c),IntergovernmentalCooperationAct of 1968
Waivers of the single State agency requirementwhich are currently operative have beengranted under authority of theIntergovernmental Cooperation Act of 1968.
Yes. ATTACHMENT 1.1-B describes these
waivers and the approved alternativeorganizational arrangements
Not applicable. Waivers are no longer ineffect.
X Not applicable. No waivers have everbeen granted.
TN No.Supersedes TN No.
Revision: HCFA-AT-80-38MAY 22, 1980
(BPP)
OMB No. 0938
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STATE PLAN-UNDER TITLE XIX OF THE SOCIAL SECURITY ACTMEDICAL ASSISTANCE PROGRAM
Citation42 CFR430.10AT-79-29
State/Territory:
1.1 (d)
District of Columbia
The agency named in paragraph 1.1 (a)has responsibilityfor all determinations of el~gibilityfor Medicaid under this plan.
X Determinations ot eligibility forMedicaid under this plan are madeby the agencies specified inATTACHMENT 1.2-8. There is a
written agreement between theagency named in paragraph 1.1 (a)and other agencies making suchdeterminations for specific groupscovered under this plan. Theagreement defines therelationships and activeresponsibilities of the agencies.
TN No.Supersedes TN No.
Approval UA¥R E f fee t ive --D;;teTO/t;TtrrI
Revision: HCFA-AT-80-38
MAY 22, 1980(BPP)
OMB No. 0938
Page 6
STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACTMEDICAL ASSISTANCE PROGRAM
State/Territory: District of Columbia
Citation42 CFR 431.10AT-79-29
TN No.Supersedes TN No.
1.1 (e) All other provisions of this planare administered by the Medicaidagency except for those functionsfor which final authority has beengranted to a Professional StandardsReview Organization under Title XIof the Act.
(f) All other requirements of 42 CPR431.10 are met.
Revision: HCFA-AT-80-38
MAY 22, 1980(BPP)
OMB No. 0938
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STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT
MEDICAL ASSISTANCE PROGRAM
State/Territory: District of Columbia
Citation42 CFR 431.11AT-79-29
1.2 Organization for Admini~~ration
(a) ATTACHMENT 1.2-A contains adescription of the organizationand functions of the Medicaid
agency and an organization chartof the agency.
(b) Within the State agency, theDEPARTMENT OF HEALTH CARE
FINANCE has been designated asthe medical assistance unit.ATTACHMENT 1.2-A contains a
description of organization andfunctions of the medicalassistance unit and an
organization chart of the unit.
(c) ATTACHMENT 1.2-C contains a
description of the kinds andnumbers of professional medicalpersonnel and supporting staffused in the administration of
the plan and theirresponsibilities.
(d) Eligibility determinations aremade by State or local staff ofan agency other than the agencynamed in paragraph l.l(a).ATTACHMENT 1.2-B contains a
description of the staffdesignated to make suchdeterminations and the functions
they will perform.
Not applicable. Onlystaff of the agency named inparagraph l.l(a) make suchdeterminations.
TN No. ApprovalSupersedes TN No.
Effective Dc..te ftrii)roa~j:>R 2 8 2009 ~-r ---
Revision: HCFA-AT-BO-38
MAY 22, 1980(BPP)
OMB No. 0938
Page B
STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACTMEDICAL ASSISTANCE PROGRAM
State/Territory: District of Columbia
Citation42 CFR 431.50(b)AT-79-29
TN No.Supersedes TN No.
1.3 Statewide Operation
The plan is in operation on a Statewidebasis in accordance with all
requirements of 42 CFR.431.50.
X The plan lS State administered.
The plan is administered by thepolitical subdivisions of the Stateand is mandatory on them.
Approval DaAf>
Revision: HCFA-AT-80-38
MAY 22, 1980(BPP)
OMB No. 0938
E'age 9
STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACTMEDICAL ASSISTANCE PROGRAM
State/Territory: District of Columbia
Citation42 CFR431.12(b)AT-78-90
42 CFR438.104
TN No.Supersedes TN No.
1.4 State Medical Care Advisory Committee
There is an advisory committee tothe Medicaid agency director onhealth and medical care Servicesestablished in accordance with and
meeting all the requirements of 42CFR 431.12.
[X) The State enrolls recipients inMCO, PIHP, PAHP, and/or PCCMprograms. The State assures thatit complies with 42 CFR 438.104 (c)to consult with the Medical Care
Advisory Committee in the review oE
managed care marketing materials.
Revision: HCFA-PM-94-3APRIL 1994
(MB)
OMB No. 0938
Page 9a
STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT
State/Territory: District of Columbia
Citation1928 of theAct
1.5 Pediatric Immunization Program
1. The State has implemented a program forthe distribution of pediatric vaccinesto program-registered providers for theimmunization of federally vaccineeligible children in accordance withsection 1928 as indicated below.
a. The State program will provide eachvaccine-eligible child withmedically appropriate vaccinesaccording to the schedule developedby the Advisory Committee onImmunization Practice and without
charge for the vaccines.
b. The State will outreach and
encourage a variety of providers toparticipate in the program and toadminister vaccines in multiplesettings, e.g., private health careproviders, providers that receivefunds under Title v of the Indian
Health Care Improvement Act, healthprograms or facilities operated byIndian tribes, and maintain a listof program-registered providers.
c. With respect to any population ofvaccine-eligible children asubstantial portion of whoseparents have limited ability tospeak the English language, theState will identify programregistered providers who are ableto communicate with this vaccine
eligible population in the languageand cultural context which is mostappropriate.
d. The State will instruct programregistered providers to determineeligibility in accordance withsection 1928(b) and (h) of theSocial Security Act.
TN No.
Supersedes TN No.
Effective Date /6/0 Itorer I
Revision: HCFA-PM-94-3APRIL 1994
OMB No. 0938
page 9b
STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT
State/Territory: District of Columbia
Citation1928 of theJl.ct
TN No.Supersedes TN No.
1.5 Pediatric Immunization Program(continued)
e. The State will assure that no
program-registered provider willcharge more for the administrationof the vaccine than the regionalmaximum established by theSecretary. The State will informprogram-registered providers of themaximum fee for the administrationof vaccines.
f. The State will assure that no
vaccine-eligible child is deniedvaccines because of inability topay an administration fee.
g. Except as authorized under section1915 (b) of the Social Security Actor as permitted by the Secretary toprevent fraud or abuse, the Statewill not impose any additionalqualifications or conditions, inaddition to those indicated above,in order for a provider to qualifyas a program-registered provider.
Revision: HCFA-PM-94-3APRIL 1994
OMB No. 0938
Page 9c
STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT
State/Territory: District of Columbia
Citation1928 of theJl.ct
TN No.
Supersedes TN No.
1.5 Pediatric Immunization ProgE~~(continued)
2. The State has not modified or repealedany Immunization Law in effect as of May1, 1993 to reduce the amount of healthinsurance coverage of pediatricvaccines.
3. The State Medicaid Agency hascoordinated with the State Public Health
Agency in the completion of thispreprint page.
4. The State agency with overall
responsibility for the implementationand enforcement of the provisions ofsection 1928 is:
