Code of the District of Columbia

§ 44–664.05. Medicaid outpatient hospital access payments; payments to MCOs.

(a) For visits and services beginning October 1, 2020, the District shall pay managed care organizations ("MCOs") at a rate sufficient to support payments to hospitals located in the District for outpatient services at a rate that is not less than 130% of the District Fiscal Year 2020 fee-for-service base rate and shall direct MCOs to pay such rate to their participating hospitals located in the District for such services.

(b) No payment shall be made under this section until such time that the Centers for Medicare and Medicaid Services approves the Medicaid State Plan amendment, associated template, and other authorities authorizing the Medicaid payments described in this section.

(c) The Medicaid payment methodologies authorized under this section shall not be altered unless such alteration is necessary to gain approval from the Centers for Medicare and Medicaid Services.


(Dec. 13, 2017, D.C. Law 22-33, § 5066, 64 DCR 7652; Oct. 30, 2018, D.C. Law 22-168, § 5032(d), 65 DCR 9388; Sept. 11, 2019, D.C. Law 23-16, § 5082(d), 66 DCR 8621; Dec. 3, 2020, D.C. Law 23-149, § 5002(e), 67 DCR 10493.)

Emergency Legislation

For temporary (90 days) amendment of this section, see § 5082(d) of Fiscal Year 2020 Budget Support Congressional Review Emergency Act of 2019 (D.C. Act 23-112, Sept. 4, 2019, 66 DCR 11964).

For temporary (90 days) amendment of this section, see § 5082(d) of Fiscal Year 2020 Budget Support Emergency Act of 2019 (D.C. Act 23-91, July 22, 2019, 66 DCR 8497).

For temporary (90 days) amendment of this section, see § 5032(d) of Fiscal Year 2019 Budget Support Congressional Review Emergency Act of 2018 (D.C. Act 22-458, Oct. 3, 2018, 65 DCR 11212).

For temporary (90 days) amendment of this section, see § 5032(d) of Fiscal Year 2019 Budget Support Emergency Act of 2018 (D.C. Act 22-434, July 30, 2018, 65 DCR 8200).

For temporary (90-day) creation of this section, see § 5066 of the Fiscal Year 2018 Budget Support Congressional Review Emergency Act of 2017, effective October 24, 2017 (D.C. Act 22-167; 64 DCR 10802).

For temporary (90-day) creation of this section, see § 5066 of the Fiscal Year 2018 Budget Support Emergency Act of 2017, effective July 20, 2017 (D.C. Act 22-104; 64 DCR 7032).