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Government and People
Healthy DC Act of 2008
Add new subtitles to Title V to read as follows:
TITLE V. HUMAN SUPPORT SERVICE.
SUBTITLE X. HEALTHY DC.
Sec. 50XX. Short title.
This subtitle may be cited as “Healthy DC Act of 2008”.
Sec. 50XX. Definitions.
For purposes of this subtitle, the term “health insurer” means any person that provides one or more health benefit plans or insurance in the District of Columbia, including an insurer, a hospital and medical services corporation, a fraternal benefit society, a health maintenance organization, a multiple employer welfare arrangement, or any other person providing a plan of health insurance subject to the authority of the Commissioner of the Department of Insurance, Securities and Banking.
Sec. 50XX. Establishment of Healthy DC Program; administration.
(a) There is established the Healthy DC Program (“Program”) which shall provide affordable health benefits to eligible individuals.
(b) The Program shall be administered by the Department of Health Care Finance, established by the Department of Health Care Finance Establishment Act of 2007, effective February 27, 2008 (D.C. Law 17-109; 55 DCR 216).
(c) The Program shall be funded through the Healthy DC Fund as established by section 15b of the Hospital and Medical Services Corporation Regulatory Act of 1996, effective March 2, 2007 (D.C. Law 16-19; D.C. Code § 31-3514.02).
(d) The Program shall be subject to the availability of funding. Nothing in this subtitle shall be construed to create or constitute an entitlement to health insurance or health or medical benefits.
Sec. 50XX. Program eligibility.
(a) An individual shall be eligible for the Program if the individual:
(b) Eligibility for the Program shall not be subject to any pre-existing condition exclusions.
Sec. 50XX. Program benefits; affordability.
(a) The Program shall provide, at minimum, health and medical benefits that are equal to those provided to individuals enrolled in the D.C. HealthCare Alliance.
(b) The Program shall limit annual premium costs to 3% or less of a Program participant’s gross income.
Sec. 50XX. Program implementation.
(a) The Mayor shall make the Program available to eligible individuals by July 1, 2009.
(b) To meet the deadline set forth in subsection (a) of this section, the Mayor is authorized to enter into a contract with one or more health insurers to administer the Program.
(c) Any contract entered into pursuant to this section shall require annual reporting of clinical quality measurements and utilization data to the Mayor.
Sec. 50XX. Prohibitions.
It shall be unlawful for a health insurer to eliminate or restrict the availability of a health insurance plan offered in the District with the intent of shifting beneficiaries to the Program. An entity found to be in violation of this section shall be subject to a fine of not less than $10,000.
Sec. 50XX. Disposition of fines and penalties.
Fines and penalties collected pursuant to this act shall be deposited in the Healthy DC Fund.
Sec. 50XX. Rulemaking.
The Mayor, pursuant to Title I of the District of Columbia Administrative Procedure Act, approved October 21, 1968 (82 Stat. 1204; D.C. Official Code § 2-501 et seq.), shall issue rules to implement the provisions of this act.
SUBTITLE X. HEALTHY DC FUND.
Sec. 50XX. Short title.
This subtitle may be cited as “Hospital and Medical Services Corporation Regulatory Act Amendment Act of 2008”.
Sec. 50XX. Section 15b of the Hospital and Medical Services Corporation Regulatory Act of 1996, effective March 2, 2007 (D.C. Law 16-192; D.C. Official Code § 31-3514.02.), is amended to read as follows:
SUBTITLE X. MEDICAID STATE PLAN AMENDMENT
Sec. 50XX. Short title.
This subtitle may be cited as “Medicaid Fee-For-Service State Plan Amendment Act of 2008”.
Sec. X. Medicaid fee-for-service rate increases.
By October 1, 2008, the Mayor shall submit to the Council a Medicaid state plan amendment that will increase the specialty physician and primary care physician reimbursement rates under the District Medicaid fee-for-service program to match the specialty physician and primary care physician reimbursement rates under the federal Medicare program.
Add a new subtitle to read as follows:
SUBTITLE X. HEALTHY DC REVENUE.
Sec. X. Short title.
This subtitle may be cited as “Healthy DC Revenue Act of 2008”.
Sec. X. The Health Maintenance Organization Act of 1996, effective April 9, 1997 (D.C. Law 11-235; D.C. Official Code § 31-3401 et seq.) is amended by adding a new section 4a to read as follows:
Sec. X. Title 47 of the District of Columbia Official Code is amended as follows:
(a) Section 47-2402(a) is amended by striking the phrase “$.05 for each cigarette.” and inserting the phrase “$.10 for each cigarette.” in its place.
(b) Section 47-2608(a) is amended as follows:
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