reglab/housing_qa huggingface dataset:
DC Code § 44-111.01 (2021)
2021 District of Columbia Code|Title 44 - Charitable and Curative Institutions|Chapter 1 - Assisted Living Residence Regulation|Subchapter XI - Insurance|§ 44-111.01. Insurance for Assisted Living Residences

(a) Each ALR shall carry insurance for at least the following: (1) Hazards (fire and extended coverage) in the amount of $500.00 per resident to protect belongings with a minimum of $2,000 of coverage per facility; (2) Premises, personal injury, and products liability at least in the following amounts: (A) For one to 2 beds, $100,000 per occurrence; (B) For 3 to 9 beds, $300,000 per occurrence; and (C) For 10 or more beds, $500,000 per occurrence; and (3) Incidental malpractice coverage specific to the duties required of an ALA manager or any staff member in the amount of at least $100,000. (b) If an ALR is not owned by the operator or manager, the operator or manager shall obtain proof of the owner’s premises liability coverage, such as a certificate of standard landlord coverage, or shall place the owner on the operator’s or manager’s policy as an additional named insured.  (June 24, 2000, D.C. Law 13-127, § 1101, 47 DCR 2647.)
DC Code § 44-112.01 (2021)
2021 District of Columbia Code|Title 44 - Charitable and Curative Institutions|Chapter 1 - Assisted Living Residence Regulation|Subchapter XII - Appeals|§ 44-112.01. Appeals from actions of the Mayor

A person or licensee aggrieved by an action of the Mayor under this chapter may appeal the Mayor’s action by filing a request for hearing as provided in § 44-505.  (June 24, 2000, D.C. Law 13-127, § 1201, 47 DCR 2647.)
DC Code § 44-113.01 (2021)
2021 District of Columbia Code|Title 44 - Charitable and Curative Institutions|Chapter 1 - Assisted Living Residence Regulation|Subchapter XIII - Rulemaking|§ 44-113.01. Rulemaking by the Mayor

The Mayor shall promulgate proposed rules where necessary to supplement the provisions of this chapter. The proposed rules shall be submitted to the Council for a 45-day period of review, excluding Saturdays, Sundays, legal holidays, and days of Council recess. If the Council does not approve or disapprove the proposed rules, in whole or in part, by resolution within the 45-day review period, the proposed rules shall be deemed approved.  (June 24, 2000, D.C. Law 13-127, § 1301, 47 DCR 2647.)  Delegation of Authority Delegation of Authority Pursuant to D.C. Law 13-127, the “Assisted Living Residence Regulatory Act of 2000”, see Mayor’s Order 2005-137, September 27, 2005 ( 53 DCR 155).
DC Code § 44-114.01 (2021)
2021 District of Columbia Code|Title 44 - Charitable and Curative Institutions|Chapter 1 - Assisted Living Residence Regulation|Subchapter XIV - Applicability|§ 44-114.01. Implementation. [Repealed]

Repealed.  (June 24, 2000, D.C. Law 13-127, § 1501, 47 DCR 2647; Aug. 16, 2008, D.C. Law 17-219, § 7024, 55 DCR 7598.)  Short Title Short title: Section 7024 of D.C. Law 17-219 provided that subtitle J of title VII of the act may be cited as the “Elimination of Subject-to-Appropriations Contingencies Amendment Act of 2008”.
DC Code § 44-301.02 (2021)
2021 District of Columbia Code|Title 44 - Charitable and Curative Institutions|Chapter 3 - Grievance Procedures for Health Benefits Plans|Subchapter I - Grievance and Appeals Procedure|§ 44-301.02. Medicare not applicable

(a) The provisions of subchapter I of this chapter shall not apply in cases directly involving coverage determinations or benefit requirements under the federal Medicare program. The provisions of subchapters II and III of this chapter shall not apply in cases directly involving federal Medicare benefits. (b) Any complaint by a member involving coverage or benefits provided pursuant to the federal Medicare program shall be resolved in accordance with federal laws, regulations, and procedures established for fair hearings and appeals for the Medicare programs and with any appropriate District law.  (Apr. 27, 1999, D.C. Law 12-274, § 102, 46 DCR 1294.)  Prior Codifications 1981 Ed., § 32-571.2.
DC Code § 44-301.04 (2021)
2021 District of Columbia Code|Title 44 - Charitable and Curative Institutions|Chapter 3 - Grievance Procedures for Health Benefits Plans|Subchapter I - Grievance and Appeals Procedure|§ 44-301.04. Grievance process

(a) A member or member representative may appeal any adverse benefit determination decision resulting in a rescission, denial, termination, or other limitation of a benefit in accordance with the provisions of this chapter. (b) At the time an insurer denies, reduces, terminates, or limits a benefit, an insurer shall provide to the affected member or member representative a written description of the procedures for filing appeals, including procedures to request expedited internal or external review if the matter concerns an emergency or urgent medical condition. The notice shall adhere to requirements of Title XXVII of the Public Health Service Act, approved July 1, 1944 (42 U.S.C. § 300gg et seq.), and the Employee Retirement Income Security Act of 1974, approved September 2, 1974 (Pub. L. No. 93-406; 88 Stat. 829), and shall include information sufficient to identify the claim, the reason for the denial, any standards relied on to deny the claim, contact information for the Health Care Ombudsman, and notice of the right of the claimant to receive free of charge all documents relevant to the claim. (c) The appeal process shall consist of 2 separate appeal levels: (1) Review by the insurer; and (2) External review by an independent review organization. (d) Nothing in the health benefits plan shall prohibit a member or member representative from discussing or exercising the right to appeal pursuant to this section. (e)(1) The insurer shall notify a member seeking a resolution of an adverse benefit determination about the: (A) Availability of the Health Care Ombudsman; (B) Right to review; and (C) Procedures for obtaining continued coverage pending the outcome of the grievance. (2) For grievances and appeals concerning urgent or emergency medical conditions, the member has the right to continued coverage at the level of benefits provided before the reduction, termination, or limitation, pending the outcome of the appeal. (f)(1) Any request that a physician, with knowledge of the covered person’s medical condition, determines involves an emergency or urgent medical condition shall be treated as an urgent care request. (2) An individual acting on behalf of the health insurer shall apply the judgment of a prudent layperson who possesses an average knowledge of health and medicine to determine if other requests involve an emergency or urgent medical condition. (3) For the purposes of expedited external review, the Director, or the Director’s designee, shall apply the judgment of a prudent layperson that possesses an average knowledge of health and medicine to determine if other requests involve an emergency or urgent medical condition.  (Apr. 27, 1999, D.C. Law 12-274, § 104, 46 DCR 1294; Mar. 19, 2013, D.C. Law 19-229, § 2(c), 59 DCR 13592.)  Prior Codifications 1981 Ed., § 32-571.4. Effect of Amendments The 2013 amendment by D.C. Law 19-229 rewrote (a) through (c); and added (e) and (f).
DC Code § 44-301.05 (2021)
2021 District of Columbia Code|Title 44 - Charitable and Curative Institutions|Chapter 3 - Grievance Procedures for Health Benefits Plans|Subchapter I - Grievance and Appeals Procedure|§ 44-301.05. Informal internal review. [Repealed]

Repealed.  (Apr. 27, 1999, D.C. Law 12-274, § 105, 46 DCR 1294; Mar. 19, 2013, D.C. Law 19-229, § 2(d), 59 DCR 13592.)  Prior Codifications 1981 Ed., § 32-571.5.
DC Code § 44-301.06a (2021)
2021 District of Columbia Code|Title 44 - Charitable and Curative Institutions|Chapter 3 - Grievance Procedures for Health Benefits Plans|Subchapter I - Grievance and Appeals Procedure|§ 44-301.06a. Appeals of rescissions to the Department of Insurance, Securities, and Banking

If an insurer denies a member or member representative’s appeal of a rescission, the insurer shall provide the member or member representative and the Department of Insurance, Securities, and Banking with a written explanation of why the insurer found that there was fraud or misrepresentation of a material fact. The notice shall explain the member’s right to appeal to the Department of Insurance, Securities, and Banking.  (Apr. 27, 1999, D.C. Law 12-274, § 106a; as added Mar. 19, 2013, D.C. Law 19-229, § 2(f), 59 DCR 13592.)  Effect of Amendments The 2013 amendment by D.C. Law 19-229 added this section.
DC Code § 44-301.09 (2021)
2021 District of Columbia Code|Title 44 - Charitable and Curative Institutions|Chapter 3 - Grievance Procedures for Health Benefits Plans|Subchapter I - Grievance and Appeals Procedure|§ 44-301.09. Assessment of insurers

The Mayor shall assess all insurers to cover all the costs of administering this chapter. The Mayor shall promulgate regulations to determine the assessment formula.  (Apr. 27, 1999, D.C. Law 12-274, § 109, 46 DCR 1294.)  Prior Codifications 1981 Ed., § 32-571.9. Delegation of Authority Delegation of authority pursuant to D.C. Law 12-274, the “Health Benefits Plan Members Bill of Rights Act of 1998”, see Mayor’s Order 99-159, October 13, 1999 ( 46 DCR 8842).
DC Code § 44-301.10 (2021)
2021 District of Columbia Code|Title 44 - Charitable and Curative Institutions|Chapter 3 - Grievance Procedures for Health Benefits Plans|Subchapter I - Grievance and Appeals Procedure|§ 44-301.10. Reporting requirements

(a) Every insurer shall submit to the Director, an annual grievance report, that chronicles all grievance activity during the preceding year. The Director shall develop a system for classifying and categorizing grievances and appeals that all insurers and independent review organizations will use when collecting, recording, and reporting grievance and appeals information. The Director shall also develop a reporting form for inclusion in the annual grievance report that shall include the following information: (1) The name and location of the reporting insurer; (2) The reporting period in question; (3) The names of the individuals responsible for the operation of the insurer’s grievance system; (4) The total number of grievances received by the insurer, categorized by cause, insurance status, and disposition; (5) The total number of requests for expedited review, categorized by cause, length of time for resolution, and disposition; and (6) The total number of requests for external review, categorized by cause, length of time for resolution, and disposition. (b) The Director shall provide current and aggregate information about each health benefits plan’s grievance and appeals activity to the public. (c) The Director shall develop appropriate annual reporting requirements for independent review organizations. (d) The Director shall submit an annual report to the Council and the public concerning the status of the grievance and appeal procedures of all health benefits plans in the District, including external appeals. The report shall summarize grievances by category and by health benefits plan and shall include the number of decisions upholding and reversing each grievance and the length of time for complete resolution of the grievance. The Director shall, based upon individual cases and the patterns of grievance and appeals activity, include in the annual report recommendations concerning additional health consumer protections.  (Apr. 27, 1999, D.C. Law 12-274, § 110, 46 DCR 1294.)  Prior Codifications 1981 Ed., § 32-571.10.
DC Code § 44-301.11 (2021)
2021 District of Columbia Code|Title 44 - Charitable and Curative Institutions|Chapter 3 - Grievance Procedures for Health Benefits Plans|Subchapter I - Grievance and Appeals Procedure|§ 44-301.11. Availability of District external review procedures for self-insured plans

A group health plan that is located in the District but that is not subject to District regulation may voluntarily use the District’s external review system; provided, that it pays the full costs of external review and adheres to the procedures set forth in § 44-301.07.  (Apr. 27, 1999, D.C. Law 12-274, § 111; as added Mar. 19, 2013, D.C. Law 19-229, § 2(i), 59 DCR 13592.)  Effect of Amendments The 2013 amendment by D.C. Law 19-229 added this section.
DC Code § 44-302.01 (2021)
2021 District of Columbia Code|Title 44 - Charitable and Curative Institutions|Chapter 3 - Grievance Procedures for Health Benefits Plans|Subchapter II - Access to Specialists as Primary Care Providers|§ 44-302.01. Specialists as primary care providers

(a) A health benefits plan shall permit a member with chronic disabling or life threatening conditions to choose a health care specialist as the member’s primary care provider. The specialist must be a participant in the health benefits plan and be available to attend to the member. (b) A specialist chosen by a member pursuant to subsection (a) of this section, shall be permitted to treat the member without the member first receiving a referral from another health care provider. The specialist may authorize referrals, procedures, tests, and medical services subject to the terms of a treatment plan developed by the specialist and approved by the insurer. (c) A health benefits plan shall permit a member with a chronic disabling or life threatening condition to have direct access to a specialist qualified to treat the condition, subject to initial referral by the member’s primary care provider and a treatment plan approved by the member’s primary care provider. Such treatment plan shall ensure that the member will receive covered medically necessary procedures, tests, and medical services.  (Apr. 27, 1999, D.C. Law 12-274, § 201, 46 DCR 1294.)  Prior Codifications 1981 Ed., § 32-572.1.
DC Code § 44-302.02 (2021)
2021 District of Columbia Code|Title 44 - Charitable and Curative Institutions|Chapter 3 - Grievance Procedures for Health Benefits Plans|Subchapter II - Access to Specialists as Primary Care Providers|§ 44-302.02. Standing referrals to specialists

(a) In general, subject to subsection (b) of this section, a health benefits plan shall permit a member to receive medically necessary or appropriate specialty care for more than one visit without having to obtain the insurer’s approval for subsequent visits authorized by a primary care provider. (b) Subsection (a) of this section shall not apply to specialty care if the insurer informs the member, orally and in writing, of any limitation on the choice of participating providers with respect to such care.  (Apr. 27, 1999, D.C. Law 12-274, § 202, 46 DCR 1294.)  Prior Codifications 1981 Ed., § 32-572.2.
DC Code § 44-302.03 (2021)
2021 District of Columbia Code|Title 44 - Charitable and Curative Institutions|Chapter 3 - Grievance Procedures for Health Benefits Plans|Subchapter II - Access to Specialists as Primary Care Providers|§ 44-302.03. Direct access to qualified specialists for females’ health services

(a) Every health benefits plan that requires or provides a member with the opportunity to designate a participating primary care provider, shall permit a member who is female to designate as her primary care provider a participating physician or advance practice registered nurse who specializes in obstetric and gynecology. (b) If a member who is female does not designate a participating physician or advance practice registered nurse as described in subsection (a) of this section as her primary care provider, the health benefits plan may not require authorization or referral by the member’s primary care provider, or otherwise, in order for the member to receive routine obstetrical or gynecological services from a participating obstetrician or gynecologist or advance practice registered nurse described in subsection (a) of this section. (c) For the purposes of this section “routine obstetrical and gynecological services” means the full scope of medically necessary services provided by the obstetrician or gynecologist or advance practice registered nurse described in subsection (a) of this section in the care of, or related to, the female reproductive system and breasts and in performing annual screening and immunizations for disorders and diseases in accordance with nationally recognized medical practice. (d) Nothing in this section shall prohibit an insurer or Health Maintenance Organization from requiring a participating obstetrician or gynecologist or advance practice registered nurse as described in subsection (a) of this section to provide written notification to the covered female’s primary care physician of any visit to such obstetrician or gynecologist or advance practice registered nurse. The notification may include a description of the health care services rendered at the time of the visit.  (Apr. 27, 1999, D.C. Law 12-274, § 203, 46 DCR 1294.)  Prior Codifications 1981 Ed., § 32-572.3.
DC Code § 44-303.01 (2021)
2021 District of Columbia Code|Title 44 - Charitable and Curative Institutions|Chapter 3 - Grievance Procedures for Health Benefits Plans|Subchapter III - Notification of Health Care Provider Termination; Continuance of Coverage|§ 44-303.01. When a health care provider leaves a plan

If a contract between an insurer and a health care provider is terminated by either party for any reason other than termination for failure to meet applicable quality standards of care or fraud, and a member is undergoing a course of treatment from the physician at the time of the termination, the insurer shall notify the member on a timely basis of the termination. When medically necessary, persons with serious illness undergoing a course of treatment or who are in the second trimester of a pregnancy shall be permitted to continue to receive medically necessary covered services, with respect to the cause of treatment, by the physician or nurse midwife during a transitional period of at least 90 days from the date of the notice under the same terms and conditions as specified under the provider contract.  (Apr. 27, 1999, D.C. Law 12-274, § 301, 46 DCR 1294.)  Prior Codifications 1981 Ed., § 32-573.1.
DC Code § 44-304.01 (2021)
2021 District of Columbia Code|Title 44 - Charitable and Curative Institutions|Chapter 3 - Grievance Procedures for Health Benefits Plans|Subchapter IV - Regulations and Standards|§ 44-304.01. Regulations and standards; compliance

(a) Within 120 days of April 27, 1999, the Director shall promulgate any regulations and standards as may be necessary to carry out the purposes of this chapter. (b) Health benefits plans and insurers subject to this chapter shall comply with the regulations promulgated pursuant to subsection (a) of this section for contracts issued or renewed on or after 120 days from the promulgation of final regulations pursuant to subsection (a) of this section.  (Apr. 27, 1999, D.C. Law 12-274, § 401, 46 DCR 1294.)  Prior Codifications 1981 Ed., § 32-574.1.
DC Code § 44-503 (2021)
2021 District of Columbia Code|Title 44 - Charitable and Curative Institutions|Chapter 5 - Health-Care and Community Residence Facility, Hospice and Home Care Licensure|Subchapter I - Licensure|§ 44-503. Authority of Mayor

(a) The Mayor shall: (1) Ensure that licensing rules are consistent with certificate of need rules and that both are designed to facilitate the goals and objectives of the District of Columbia’s state health plan and certificate of need program; and (2) Conduct an initial inventory of facilities to determine actual physical bed capacity and operating bed capacity. (b) The Mayor shall have the authority to license bed capacity by specific, well-defined services. For hospitals, licensure by type of service shall be limited to the following categories: Medical/surgical; ICU/coronary care; OB/GYN; nursery; intermediate neonatal and neonatal intensive care; pediatrics; alcoholism/chemical dependency; rehabilitation; and psychiatric.  (Feb. 24, 1984, D.C. Law 5-48, § 4, 30 DCR 5778.)  Prior Codifications 1981 Ed., § 32-1303. Delegation of Authority Delegation of authority pursuant to D.C. Law 5-48, the “Health Care and Community Residence License Act of 1983”, see Mayor’s Order 98-137, August 20, 1998 ( 45 DCR 6587). Delegation of authority under Health-Care and Community Residence Facility, Hospice and Home Care Licensure Act of 1983, see Mayor’s Order 84-105, June 19, 1984.
DC Code § 44-553 (2021)
2021 District of Columbia Code|Title 44 - Charitable and Curative Institutions|Chapter 5 - Health-Care and Community Residence Facility, Hospice and Home Care Licensure|Subchapter II - Unlicensed Personnel Criminal Background Check|§ 44-553. Penalties for unauthorized released of criminal information

(a) Any person releasing or disclosing any information in violation of § 44-552(c) shall be guilty of a misdemeanor, and shall be punishable by the payment of a fine not greater than $300, a term of imprisonment not greater than 30 days, or both. (b) Civil fines, penalties, and fees may be imposed as sanctions for any violation of this subchapter or the rules issued pursuant to this subchapter, pursuant to Chapter 18 of Title 2. (c) No facility shall be subject to civil liability that in good faith relies on a criminal background check to terminate, or to refuse to offer employment to, any individual.  (Apr. 20, 1999, D.C. Law 12-238, § 4, 46 DCR 881.)  Prior Codifications 1981 Ed., § 32-1353.
DC Code § 44-554 (2021)
2021 District of Columbia Code|Title 44 - Charitable and Curative Institutions|Chapter 5 - Health-Care and Community Residence Facility, Hospice and Home Care Licensure|Subchapter II - Unlicensed Personnel Criminal Background Check|§ 44-554. Rules

The Mayor may issue rules to implement this subchapter, including procedures for additional enforcement actions for violation of this subchapter and the setting of fees in accordance with the provisions of subchapter I of Chapter 5 of Title 2.  (Apr. 20, 1999, D.C. Law 12-238, § 5, 46 DCR 881.)  Prior Codifications 1981 Ed., § 32-1354.
DC Code § 44-631 (2021)
2021 District of Columbia Code|Title 44 - Charitable and Curative Institutions|Chapter 6A - Medicaid Hospital Outpatient Supplemental Payments and Medicaid Hospital Inpatient Rate Supplements|Subchapter I - 2013 - 2014 Medicaid Hospital Inpatient Rate Supplement. [Expired]|§ 44-631. Definitions. [Expired]

Expired.  (Sept. 24, 2010, D.C. Law 18-223, § 5012, 57 DCR 6242.)  Emergency Legislation For temporary (90 day) addition, see § 1102 of Fiscal Year 2010 Balanced Budget Support Emergency Act of 2010 (D.C. Act 18-450, June 28, 2010, 57 DCR 5635). For temporary (90 day) addition, see § 5012 of Fiscal Year 2011 Budget Support Emergency Act of 2010 (D.C. Act 18-463, July 2, 2010, 57 DCR 6542). For temporary (90 day) addition, see §§ 1102 of Fiscal Year 2010 Balanced Budget Support Congressional Review Emergency Act of 2010 (D.C. Act 18-531, August 6, 2010, 57 DCR 8109). Temporary Legislation Section 1102 of D.C. Law 18-222 added a section to read as follows: “Sec. 1102. Definitions. “For the purposes of this act, the term: “(1) ‘Hospital’ has the same meaning as set forth in section 2(a)(1) of the Health-Care and Community Residence Facility, Hospice and Home Care Licensure Act of 1983, effective February 24, 1984 (D.C. Law 5-48; D.C. Official Code § 44-501(a)(1)), but excludes St. Elizabeths Hospital and any hospital operated by the federal government. “(2) ‘Medicaid’ means the medical assistance programs authorized by title XIX of the Social Security Act, approved July 30, 1965 (79 Stat. 343; 42 U.S.C.§ 1396 et seq.), and by section 1 of 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 administered by the Department of Health Care Finance.” Section 2002(b) of D.C. Law 18-222 provided that the act shall expire after 225 days of its having taken effect.