This chapter establishes non-Medicaid local fund reimbursement rates for substance use disorder services provided to District residents aged 21 and older by DBH-certified substance use disorder providers. Rates mirror equivalent Medicaid reimbursement rates and are governed by the Human Care Agreement between the Department and the provider. Reimbursement is not guaranteed and is subject to appropriated funds availability.
View official source6400 PURPOSE 6400.1 This chapter establishes the reimbursement rate for services provided to eligible District residents ages twenty-one (21) and older by Department of Behavioral Health (Department) certified substance use disorder providers, as this term is defined in Chapter 63 (Certification Standards for Substance Use Disorder Treatment and Recovery Providers) of Subtitle A (Mental Health) of Title 22 (Health) of the District of Columbia Municipal Regulations (DCMR). 6400.2 Establishment of these reimbursement rates will allow the Department to reimburse providers using non-Medicaid local funds for services provided in accordance with the Human Care Agreement to those clients who are not eligible for Medicaid funding, and for those services that are not reimbursable by Medicaid. Reimbursement rates using non-Medicaid local funds are equivalent to the reimbursement rates for equivalent services that may be reimbursable by Medicaid. 6400.3 Nothing in this chapter grants to a certified substance use disorder provider the right to reimbursement for costs of substance use disorder services and supports. Eligibility for reimbursement is determined solely by the Human Care Agreement between the Department and the certified substance use disorder provider, and reimbursement is subject to the availability of appropriated funds. SOURCE: Final Rulemaking published at 63 DCR 6936 (May 6, 2016). District of Columbia Municipal Regulations Mental Health 22-A DCMR § 6400