Health Equity
Medicaid Enrollment Touches 39% of the Residents of The District of Columbia; DC’s 70/30 FMAP is Vital for the Maintenance of Health & Human Services
A reduction in the District’s FMAP would not lead to long-term government savings and would have a ripple effect throughout the entire health system in the DMV, crippling access to care for not only Medicaid beneficiaries but also all those who live, work, and visit the District of Columbia, including members of Congress and their staffs.
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Why does DC receive an Enhanced FMAP Rate?
The DC FMAP rate of 70% established by the Revitalization Act resulted from bipartisan analysis, discussion, and negotiation by Congressional leadership aiming to balance fairness with the District’s restricted ability to generate revenue. Congress recognized that the District of Columbia faces unique financial challenges due to its non-state status and the significant amount of federally-owned land within its boundaries. The District is unable to tax non-residents’ earnings, so these workers pay no taxes to support the infrastructure and services, such as roads, public safety and emergency services that they benefit from in the District. The District is also unable to tax up to 40% of the real property within its borders due to statutory restrictions.
Why are we concerned about DC's FMAP now?
Members of Congress have proposed reducing the DC FMAP to the statutory minimum for all other states, which is currently 50% (but could be reduced even more). Such a change would impact every physician and every practice, regardless of type, location, and payers contracted. Even practices who take no insurance will not be able to send patients for specialist care, hospital admissions, or other types of care.
What can MSDC members do?
- If you know a member of Congress or staffer, reach out to them and share how DC cuts will hurt your patients.
- Share your relationships and outreach with hay@msdc.org so we can help coordinate advocacy efforts.
- Email hay@msdc.org if you would like to be paired with a physician member of Congress office and trained by MSDC staff on how to reach out.
Resources
- DC FMAP cut fact sheet
- California Medical Association fact sheet on Medicaid cuts
- MSDC and healthcare association letter to Congress arguing against DC FMAP changes.
- MSDC original story on Medicaid changes.
News, Statements, and Testimony on Health Equity Issues
MSDC, 14 Medical Practices and Orgs Suggest Telemedicine Allowances Remain
On Monday, MSDC and fourteen medical associations and practices sent a letter to Mayor Muriel Bowser asking her to extend certain public health emergency allowances.
The letter begins by thanking the Mayor for her scientific, fact-based leadership during the pandemic. It then notes that many of the allowances made during the public health emergency are important to post-PHE medicine. As the letter states, "these temporary changes have proven to be effective tools to preventing infectious disease as well as increasing medical care to all residents."
The letter lists four main areas for consideration:
- Expand telemedicine site of care to permit telemedicine appointments outside of medical facilities
- Permit existing relationships between patients and providers to continue across District state lines
- Support equitable reimbursement for telemedicine with in-person medical care
- Waive civil and medical liability for treatment decisions made in good faith during the public health emergency.
September 28, 2020
The Honorable Muriel Bowser
Mayor of the District of Columbia
1350 Pennsylvania Avenue NW
Washington, DC 20004
Dear Mayor Bowser –
On behalf of the physician community in the District, thank you for providing science-based, factual guidance in helping the District navigate the COVID-19 epidemic.
We represent many of the largest medical practices in the District of Columbia. Our practices have treated District residents for decades prior to 2020 and have been key to the medical response to the COVID-19 pandemic.
Treating the residents of the District during the pandemic has shown that the practice of medicine is not simply an office visit. Moving forward, we urge your administration to make permanent some of the temporary changes made during the public health emergency. These temporary changes have proven to be effective tools to preventing infectious disease as well as increasing medical care to all residents.
The changes we urge you to permanently adopt include:
• Expand telemedicine site of care to permit telemedicine appointments outside of medical facilities
• Permit existing relationships between patients and providers to continue across District state lines
• Support equitable reimbursement for telemedicine with in-person medical care
• Waive civil and medical liability for treatment decisions made in good faith during the public health emergency.
As practices who provide care for a large percentage of the District population, we urge you to take these steps to keep the District a leader in medical care during these uncertain times.
Sincerely,
Medical Society of the District of Columbia
Arthritis & Rheumatism Associates, PC
Ashesh D. Patel, MD PC
Barnard Medical Group
Capital Digestive Care
Catherine May, MD
DC Chapter, American College of Physicians
DC Section, American College of Obstetricians & Gynecologists
District of Columbia Chapter of the American College of Emergency Physicians
The GW Medical Faculty Associates
J. Desiree Pineda, MD, LLC
Maryland/DC Society of Clinical Oncology
Mid-Atlantic Permanente Medical Group
Washington Internists Group, LLC
Washington Psychiatric Society
CC: LaQuandra Nesbitt, MD; Director of the Department of Health (DC Health)
The Honorable Phil Mendelson, Chair of the Council of the District of Columbia
Wayne Turnage, Deputy Mayor for Health and Human Services
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