Opinion ID: 185216
Heading Depth: 2
Heading Rank: 2

Heading: The District of Columbia's Plan

Text: 5 The District's Medicaid plan is administered by an agency within the Department of Human Services that was called the Commission on Health Care Finance (CHCF) at the time this controversy originated. Although it has since been renamed the Medical Assistance Administration, the parties have continued to refer to the agency as the CHCF, as will we. 6 District of Columbia residents who qualify for Medicaid on the basis of their eligibility for assistance under the Temporary Assistance for Needy Families program (formerly Aid to Families with Dependent Children) are required by the District's Medicaid Managed Care Amendment Act of 1992 to enroll in managed care plans. D.C. Code Ann. S 1-359(d)(2) (1999 Repl. & Supp. 2000). Other Medicaid beneficiaries continue to receive services on a fee-for-service basis. The District pays the managed care organizations (MCOs) that administer the managed care plans a fixed pre-paid amount per Medicaid enrollee. The MCOs, in turn, are responsible for providing these enrollees with all the health care services to which they are entitled under the statute, including inpatient hospital services provided under contract between the MCOs and participating hospitals. Id. S 1-359(d)(2), (3).