Section 22-B3301. ELIGIBILITY REQUIREMENTS

 

3301.1Health care services by private health care providers under contract with the District government may be available to persons who meet the following eligibility requirements:

 

(a)The person requesting health care services is a resident of the District of Columbia on the date on which services are sought and can document residency by providing one of the following:

 

(1)A valid motor vehicle operator's permit issued by the District;

 

(2)A non-driver identification card issued by the District;

 

(3)A voter registration card with an address in the District;

 

(4)A copy of a lease or a rent receipt for real property located in the District;

 

(5)A utility bill for real property located in the District; or

 

(6)Any other item(s) of proof deemed by the Mayor or the Mayor's agent reasonably calculated to demonstrate current residency.

 

(b)The person requesting health care services has total gross household income, including child support payments, alimony and rent payments received, and any other income received on a regular basis, equal to or less than two hundred per cent (200%) of the federal poverty level, as defined by the U.S. Department of Health and Human Services, and can document income as follows:

 

(1)For a person whose source of income is earned income, one of the following:

 

(A)Originals or copies of all earnings statements received within the previous thirty (30) days;

 

(B)A copy of the first two (2) pages of a District of Columbia tax return for the most recent tax year;

 

(C)A copy of the first page of a federal tax return for the most recent tax year;

 

(D)For newly employed applicants, a copy of an offer of employment that states the amount of salary to be paid; or

 

(E)Any other item(s) of proof deemed by the Mayor or the Mayor's agent reasonably calculated to demonstrate a person's current income.

 

(2)For a person whose source of income is unearned income, one of the following:

 

(A)A copy of a Social Security or worker's compensation benefit statement;

 

(B)Proof of child support or alimony received;

 

(C)A copy of a federal tax return for the most recent tax year, including all schedules and attachments; or

 

(D)Any other unearned income, including but not limited to, stocks, bonds, annuities, private pension and retirement accounts.

 

(c)The person does not have coverage by Medicaid or Medicare and does not have other third party medical or health insurance coverage.

 

(d)An individual who lives in the District who makes a declaration at the time of service that he or she is a homeless person and states his or her intention to remain in the District shall be considered to have satisfied the residency and income requirements of paragraphs (a) and (b).

 

(e)The documentation required to be provided pursuant to paragraphs (a) and (b) shall be resubmitted every twelve (12) months to the District government or its agent, or more frequently if requested by the District government or its agent, in order to continue a person's eligibility for health services.

 

3301.2The eligibility requirements stated in Section 3301.1 above shall not apply to a person seeking health care services available on or after June 1,2006 to qualifying indigent residents through the D.C. HealthCare Alliance and paid by the Health Care Safety Net Administration ("HCSNA").

 

authority

Unless otherwise noted, the authority for this chapter is the Health Care Privatization Amendment Act of 2001, 48 DCR 7860 (July 12, 2001); and the District of Columbia Financial Responsibility and Management Assistance Act of 1995 § 207(d), D.C. Code, 2001 Ed. § 47-392.07(d).

source

Notice of Final Rulemaking published at 48 DCR 9140 (October 5, 2001); as amended by Notice of Final Rulemaking published at 53 DCR 4135 (May 19, 2006).