8708.1 Registered HIE entities that meet additional requirements and are selected by DHCF through a competitive application process shall become designated HIE entities. Designated HIE entities are partners with DHCF that operate or maintain DC HIE infrastructure or services in order to facilitate the secure, electronic exchange of health information among registered HIE entities and participating organizations in the District.

8708.2 To be eligible to apply for designation, an HIE entity must meet the requirements set forth below:

1. (a) Be a registered HIE entity;
2. (b) Meet or exceed the consumer education and auditing requirements as set forth in §§ 8709 and 8710; and
3. (c) Be organized in accordance with the District of Columbia Nonprofit Corporation Act of 2010, effective July 2, 2011 (D.C. Law 18-378; D.C. Official Code §§ 29-401.01 et seq.) or organized as a nonprofit corporation in the jurisdiction where the entity is incorporated.

8708.3 An HIE entity must apply for designation in a form and manner consistent with this section and policy guidance provided by DHCF. Application materials and guidance will be published by DHCF on its website at www.dhcf.dc.gov. DHCF shall accept applications for designation on a time-limited and periodic basis.

8708.4 DHCF shall provide notice of the designation application period by publishing the opening and closing dates of the period to the DHCF website at least thirty (30) calendar days before the application period begins.

8708.5 To be eligible to be selected as a designated HIE entity, registered HIE entities shall demonstrate compliance with the following requirements:

1. (a) Develop and submit strategic and operational plans to serve as an HDU that addresses the needs of health providers, public health agencies, Medicaid managed care organizations, health care consumers, and any other stakeholders identified by DHCF in policy guidance in achieving HIE capabilities;
2. (b) Attest to a commitment to interoperability and connectivity with registered HIE entities in the District to allow for the proliferation of DC HIE infrastructure and services and with national health information networks, if appropriate;

(c) Demonstrate necessary technical capacity to operate and implement publicly funded DC HIE infrastructure and tools;

(d) Detail the HIE entity's approach for maintaining financial sustainability, including public and private financing strategies, projected utilization, and rate structures;

(e) Provide DHCF with a copy of the HIE entity's most recently filed Internal Revenue Service Form 990;

(f) Demonstrate accreditation by a nationally recognized accreditation and certification organization for entities that electronically exchange health care data;

(g) Demonstrate HITRUST CSF-based certification, the System and Organizational Controls 2 framework of the American Institute of Certified Public Accountants, or another program that is widely adopted across the cybersecurity industry, developed and maintained by established bodies, and subject to third-party independent validation;

(h) Attest to having a plan or process in place to provide technical assistance and guidance to the system administrator of each participating organization in assigning the appropriate access to the HIE for each of its authorized users;

(i) Provide DHCF with a copy of its access and auditing plan as defined in §§ 8709.4 through 8709.6;

(j) Provide DHCF with a copy of its consumer education plan as set forth in § 8710.4; and

(k) Provide any additional information requested by DHCF or required under policy guidance provided by DHCF and published on its website at www.dhcf.dc.gov.

8708.6 HIE entities may apply for registration and designation concurrently.

8708.7 Within ninety (90) calendar days after receipt of complete information from an applicant seeking to become a designated HIE entity in the District of Columbia, DHCF shall take one of the following actions:

(a) Approve or deny the designation application in writing based on the relative strength of the application, as determined by DHCF;

(b) Deny the designation application in writing for failure to meet requirements for designation set forth in § 8708.5; or

(c) Request additional information from the applicant, in writing, to determine eligibility for designation.

8708.8 Registered HIE entities that are denied designation, in accordance with § 8708.7, shall have the opportunity to appeal DHCF’s determination in accordance with the procedure for appeals and administrative review as set forth in § 8713.

8708.9 An HIE entity’s designation shall be awarded in six (6) year terms, effective immediately. DHCF shall review an HIE entity’s designation every six (6) years from the date of designation to determine whether the HIE entity will be renewed for an additional six (6) year term. DHCF may request an HIE entity submit updated information related to the requirements set forth in § 8708.5 during review of an HIE entity’s designation.

8708.10 The designated HIE entity must comply with additional requirements as set forth in this chapter or otherwise established by DHCF through policy guidance published on its website at www.dhcf.dc.gov.

8708.11 A designated HIE entity shall submit an annual report for review by DHCF that addresses:

(a) Updates to all strategic and operational plans developed and submitted in accordance with § 8708.5(a), including plans for ensuring the necessary capacity to support clinical transactions;

(b) Rates of adoption, utilization, and transaction volume, and mechanisms to support health information exchange; and

(c) Additional information as requested by DHCF.

SOURCE: Final Rulemaking published at 66 DCR 8346 (July 19, 2019); as amended by Final Rulemaking published at 73 DCR 006876 (May 1, 2026).