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.
.png?sfvrsn=9ac2d21b_0 "What Medicaid Cuts Actually Cost")
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
Advocacy Alert: Personal Medical Record Fee Amendment Act
On April 21, the Committee on Health will hold a hearing that will discuss, among other bills, B24-0133. This legislation will introduce new requirements to the retention and sharing of medical records in the District. MSDC wants members to be aware of this bill in advance of the hearing to allow members to testify on Wednesday if desired.
The legislation was introduced by Council Chair Phil Mendelson on March 1. You can see the current text of the legislation here. Below is a breakdown of the important items for District physicians:
- The bill requires healthcare providers to provide requested medical records to a patient (or patient's representative, defined below) within 30 days of the request. The record must be the exact record requested and in the format requested (i.e., paper or electronically).
- If a provider fails to provide the record as specified, they can be fined $25 per day after 30 days, for a total fine not to exceed $5,000.
- If the patient is deceased, the request can be made by the estate, representative of the estate (temporary or permanent), or survivor of the deceased.
- The bill defines a medical record as a copy of a bill or billing record, and protected health information as defined here.
- Fees - a provider may not charge more than $6.50 for electronically producing a record and $150 for a paper record. You may not charge a "per page" fee for an electronic record, but may charge a per page fee for a paper record (but no more than $0.76 per page) and postage. You may not charge a handling fee.
- All medical records must be maintained for 10 years from the last contact with an adult patient.
- For an adolescent patient, you will be required to maintain their medical record for 10 years after the minor reaches the age of majority.
If you would like to testify on this bill or speak to someone about this legislation, contact our office at 202.466.1800 x101 or email hay [at] msdc.org.
Leave a comment