Washington, DC (STL.News) Mayor Muriel Bowser and the Department of Health Care Finance (DHCF) announced a new policy, believed to be the only one of its kind in the nation: all Medicaid and Alliance enrollees in DHCF managed care programs will have equal access to the District’s major physician groups. In November 2020, DHCF announced that the managed care program includes access to every acute care hospital in the District for both inpatient and outpatient hospital-based care. This announcement builds on that progress and marks an unprecedented moment for the District’s Medicaid program by continuing to increase access to care, one of the primary goals of DHCF’s Medicaid reform efforts.
“With the plethora of world-class care we have in our city, we are proud that for the first time, equal access to key providers is available across the Medicaid program,” said Mayor Bowser. “As we continue working to advance health equity across all eight wards, we are thankful for the leadership of our health care partners, physician groups, and FQHCs for their commitment to supporting the health and well-being of all DC residents.”
This achievement is due in part to MedStar Family Choice DC (MedStar) and the George Washington Medical Faculty Associates (GWMFA) establishing an agreement in principle to include the physician practice among health care providers in MedStar’s managed care provider network. With this agreement, MedStar joins the other two health plans in the Medicaid program –AmeriHealth Caritas DC and CareFirst Community Health Plan – that have health care provider networks which include all DC acute care hospitals, hospital-related physician groups, and federally qualified health centers (FQHCs).
This new policy was also made possible by new universal contracting requirements in the managed care contracts that became effective on October 1, 2020, and the corresponding new provisions in DHCF’s Medicaid provider agreements.
The Department of Health Care Finance is the District of Columbia’s State Medicaid Agency.