{"data":{"id":"us-dc/d.c.-code-1-307.03-perm","jurisdiction":"us-dc","citation":"D.C. Code § 1-307.03(Perm)","heading":"Medical assistance expansion program establishment.","body":"\n  *NOTE: This codification is not the most current, due to recent law changes. To see the current law (including emergency and temporary legislation, if relevant) click this link: Current Version*\n  \n\n(a)\nThe Mayor shall establish a program to expand medical assistance to adult District residents with an annual household income up to 200% of the federal poverty level.\n(1)\nThe Mayor may provide medical assistance to eligible residents by making arrangements with managed care providers either on a fee-for-service or capitated basis.\n(2)\nEnrollees of the program shall select a health maintenance organization with a current contract with the District to provide managed care services.\n(3)\nThe Mayor shall assign any enrollee who does not choose a provider within a reasonable period of time to the District of Columbia Health and Hospitals Public Benefit Corporation.\n(4)\n(A)\nIn fiscal year 2000, the Mayor may establish a pilot project to expand Medicaid coverage to not more than 2,400 adult District residents.\n(B)\nThe funding for the pilot shall be derived by amending the Disproportionate Share adjustment paid to hospitals.\n(5)\nTo implement any expansion for adult District residents with an annual household income up to 200% of the federal poverty level the Mayor shall:\n(A)\nSeek and obtain all necessary waivers of federal Medicaid statutes, rules, and regulations; and\n(B)\nAmend the District State Medicaid plan.\n\n(b)\n The Mayor shall establish a program to provide medical assistance to undocumented children not eligible for coverage under Medicaid who reside in the District and have an annual household income up to 319% of the federal poverty level for children age 18 or younger, and up to 216% of the federal poverty level for children ages 19 and 20. In determining a household income under this subsection, the Mayor may implement an income disregard amount, based on family size, of up to 5% of the federal poverty level or such higher percentage as may be authorized by the federal government as an income disregard for the determination of eligibility for Medicaid.\n(1)\nThe Mayor may provide medical assistance to eligible residents by making arrangements with managed care providers either on a fee-for-service or capitated basis.\n(2)\nUpon the Mayor's determination of a resident's eligibility for the program, the Mayor shall enroll the resident in the program and assign the enrollee to a health maintenance organization with a current contract with the District to provide health care services for program enrollees.\n(3)\nFor a period of time of at least 30 days after the Mayor's assignment of an enrollee under paragraph (2) of this subsection, the enrollee may choose to enroll in a different health maintenance organization with a current contract with the District to provide health care services for program enrollees.\n(4)\nIn fiscal year 2000, the Mayor shall establish a pilot program to provide medical assistance to not more than 500 immigrant children not eligible to be covered under Medicaid.\n\n(c)\nBeginning on October 1, 2021, the Mayor may modify the standards for eligibility to enroll in a program established by subsections (a) and (b) of this section to increase the number of District residents who would be eligible to enroll in the program to the extent such expansion is consistent with the District's budget and financial plan.\n\n(d)\nThe Mayor may provide financial support to providers to register the uninsured in conformity with the financial plan and budget.\n\n(e)\nNothing in this section, § 1-307.05, or § 1-307.06 shall be deemed to create or constitute an entitlement or right to medical coverage.","path":["Title 99. Reserved sections."],"source_url":"https://code.dccouncil.gov/us/dc/council/code/sections/1-307.03(Perm)","current_through":"2026-08-20 (D.C. Law 26-175)","vintage":"","retrieved_at":"2026-08-29T05:44:07Z","sha256":"efa8b942cb71a304cc4aa50f6b91d0de0c82d88c50b8f0dc4d7e5f411f950253","source_id":"us-dc","stale":false,"prev":"us-dc/d.c.-code-7-1405-perm","next":"us-dc/d.c.-code-4-205.52-perm"},"notice":"GroundRules: Original legal text. Not legal advice."}