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D.C. Municipal Regulations (Last Updated: September 13, 2017) |
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Title 22. HEALTH |
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SubTilte 22-B. PUBLIC HEALTH AND MEDICINE |
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Chapter 22-B33. HEALTH CARE SAFETY NET ADMINISTRATION |
Section 22-B3306. RIGHTS AND DUTIES OF APPLICANTS EFFECTIVE JUNE 1, 2006
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3306.1An applicant may voluntarily request and receive assistance in applying for benefits from IMA staff or any other person of the applicant's choice. However, an applicant may also refuse such assistance.
3306.2An applicant may name an authorized representative to act on his or her behalf. An applicant also has the right to refuse to name an authorized representative.
3306.3If an applicant names an authorized representative to act on his or her behalf, the authorized representative may apply for benefits, receive correspondence from IMA or the HCSNA, may report changes to IMA, may recertify for benefits, and may address other administrative matters.
3306.4An applicant must attend a face-to-face eligibility interview if an IMA employee requests such an interview.
3306.5An applicant (or his or her authorized representative) must report any changes in the applicant's household circumstances by contacting the IMA Change Center. Such changes would include but are not limited to changes of address, changes in income, and changes of household composition. Such changes would also include changes in health insurance status (i.e., when an applicant has any change in private health insurance coverage, Medicare, etc.). A person who fails to report a change within 10 days of the date of the change may lose their benefits; the person may also face civil and criminal penalties.
3306.6An applicant (or his or her authorized representative) must recertify on an annual basis in order to maintain his or her eligibility.
3306.7An applicant (or his or her authorized representative) may request a Fair Hearing from IMA or from the Office of Administrative Hearings to contest an eligibility determination, redetermination, or the lack thereof.
3306.8An applicant (or his or her authorized representative) must give true, accurate, and complete documents and information. A person who gives a false, deceptive, or misleading document or information may lose his or her benefits and face civil and criminal penalties.
3306.9Each applicant (or his or her authorized representative) must provide the applicant's Social Security number if he or she has one, subject to the terms of Mayor's Order 92-49 dated April 29, 1992, which governs inquiries into a person's citizenship and immigration status.
3306.10An applicant (and his or her authorized representative) must cooperate with District investigators (and their duly authorized agents) who review the applicant's eligibility record. This requirement for cooperation includes being interviewed by investigators. An applicant who fails to cooperate may lose his or her benefits. An applicant (and his or her authorized representative) may face civil and criminal penalties.
3306.11An applicant must surrender to the District Government any reimbursements or other payments received from an insurance company, court settlement, or other source for health care or medical services that were covered (and paid for) by the District of Columbia's Medicaid or Medical Assistance programs.