D.C. Mun. Regs. tit. 27, § 1611
1611.1 Notwithstanding the requirements of § 1612.1, for services provided under the District’s Medicaid Managed Care Program, for the period of October 1, 2018, through September 30, 2019, the Director sets the following monthly capitation rates per person enrolled in a contractor’s MCO to be paid to contractors selected through the solicitation, and no price evaluation factor will be required for procurement of these services:
| CLIN | Rate Cohort | DHCF Actuarially Sound Lower Bound Rates |
|---|---|---|
| 0001 DC Healthy Families Program (DCHFP) | ||
| 0001AA | Under 1 Year of Age | $454.66 |
| 0001AB | Delivery Payment | $10,025.57 |
| 0001AC | Birth Payment | $6,714.27 |
| 0001AD | Children Ages 1 through 12 Years | $196.55 |
| 0001AE | Females Ages 13 through 18 Years | $275.74 |
| 0001AF | Males Ages 13 through 18 Years | $215.73 |
| 0001AG | Females Ages 19 through 36 Years | $313.27 |
| 0001AH | Males Ages 19 through 36 Years | $228.08 |
| 0001AI | Females Ages 37 through 49 Years | $523.64 |
| 0001AJ | Males Ages 37 through 49 Years | $409.94 |
| 0001AK | Females Ages 50+ Years | $707.34 |
| 0001AL | Males Ages 50+ Years | $751.34 |
| CLIN | Rate Cohort | DHCF Actuarially Sound Lower Bound Rates |
| 0002 DC Healthcare Alliance Program | ||
| 0002AA | Females Ages 19 through 36 Years | $234.72 |
| 0002AB | Males Ages 19 through 36 Years | $186.45 |
| 0002AC | Females Ages 37 through 49 Years | $374.22 |
| 0002AD | Males Ages 37 through 49 Years | $336.57 |
| 0002AE | Females, Ages 50+ Years | $723.97 |
| 0002AF | Males, Ages 50+ Years | $828.98 |
| CLIN | Rate Cohort | DHCF Actuarially Sound Lower Bound Rates |
| 0003 271 Population2 | ||
| 0003AA | Females Ages 19 through 36 Years | $228.33 |
| 0003AB | Males Ages 19 through 36 Years | $176.77 |
| 0003AC | Females Ages 37 through 49 Years | $497.91 |
| 0003AD | Males Ages 37 through 49 Years | $331.96 |
| 0003AE | Females Ages 50+ Years | $694.63 |
|---|---|---|
| 0003AF | Males Ages 50+ Years | $558.75 |
SOURCE: Emergency Rulemaking published at 52 DCR 10423 (November 25, 2005) [EXPIRED]; as amended by Emergency Rulemaking published at 53 DCR 684 (February 3, 2006) [EXPIRED]; as amended by Emergency Rulemaking published at 54 DCR 6783 (July 13, 2007) [EXPIRED]; as amended by Final Rulemaking published at 55 DCR 12141 (November 28, 2008); as amended by Final Rulemaking published at 60 DCR 1136 (February 1, 2013); as amended by Final Rulemaking published at 66 DCR 7157 (June 14, 2019).