1. (a) Beginning October 1, 2023, the Department shall fund capitation rates for each managed care organization at a level that complies with the minimum reimbursement levels established in §§ 44-664.05(b-1) and 44-664.13(a)(2), and that ensures a covered hospital receives:

   1. (1) Maximum outpatient hospital reimbursements of 110% of the fee-for-service rate methodology set forth in the State Plan; and
   2. (2) Maximum inpatient hospital reimbursements equal to the negotiated managed care hospital rates that were in effect on March 31, 2023, for the managed care organization for inpatient hospital services.
2. (b) If necessary to ensure federal concurrence with the provisions of this section, the Department shall, by September 30, 2023, submit a state plan amendment or a managed care directed payment proposal to the Center for Medicare and Medicaid Services.
3. (c) This section shall expire on September 30, 2027.

History

Sept. 6, 2023, D.C. Law 25-50, § 5013