D.C. Mun. Regs. tit. 29, § 4207
Records and Confidentiality of Information
Authority: Section 6(6) of the Department of Health Care Finance Establishment Act of 2007, effective February 27, 2008 (D.C. Law 17-109; D.C. Official Code § 7-771.05(6)), An Act To enable the District of Columbia to receive Federal financial assistance under title XIX of the Social Security Act for a medical assistance program, and for other purposes, approved December 27, 1967 (81 Stat. 744; D.C. Official Code § 1-307.02), and Mayor’s Order 2024-115, dated July 1, 2024. Source: Final Rulemaking published at 50 DCR 9025 (October 24, 2003); as amended by Final Rulemaking published at 64 DCR 6784 (July 21, 2017); as amended by Final Rulemaking published at 72 DCR 004996 (April 25, 2025).District of Columbia, Office of the Secretary
4207 REIMBURSEMENT: GENERAL
4207.1 The MAA shall not reimburse any provider of waiver services who:
- (a) Fails to comply with any applicable regulation in this chapter;
- (b) Fails to comply with all applicable federal and District of Columbia laws, rules, and regulations; and
- (c) Fails to comply with all applicable transmittals, rules, manuals and other requirements of the MAA.
4207.2 Each provider of waiver services shall agree to accept as payment in full the amount determined by MAA as reimbursement for the authorized waiver services provided to recipients.
4207.3 Each provider shall agree to bill any and all known third-party payers prior to billing Medicaid.
SOURCE: Final Rulemaking published at 50 DCR 9025 (October 24, 2003).