District of Columbia Administrative Code

2558 SPECIAL ELIGIBILITY CRITERIA FOR REFERRAL TO THE LOCAL RENT SUPPLEMENT PROGRAM - APPLICATION AND RIGHT TO APPEAL 2558.1 An authorized representative may apply on behalf of the applicant, if the applicant provides a written and signed statement stating why the applicant canno…

2562 LGBTQ HOMELESS YOUTH SHELTER BED GRANT PROGRAM 2562.1 In accordance with Section 28(c) of the Homeless Services Reform Act of 2005, effective October 22, 2005 (D.C. Law 16-35; D.C. Official Code § 4-755.01(c)) (HSRA), as amended, a minimum of ten (10) beds shall be maintaine…

2563 LGBTQ YOUTH SERVICES AND DATA COLLECTION 2563.1 Homeless services provided by the Department or its designee shall include services specifically designed to alleviate the high risk of homelessness faced by LGBTQ youth. 2563.2 Year-round data collection on homeless youth and …

2570 TARGETED AFFORDABLE HOUSING PROGRAM – PURPOSE AND SCOPE 2570.1 The purpose of the Targeted Affordable Housing Program (TAH) is to combine rental assistance with supportive services to individuals and families who: (a) Are chronically homeless or are at risk of chronic homele…

2571 TAH – ELIGIBILITY AND PRIORITIZATION CRITERIA 2571.1 In order to be eligible for participation in TAH, a client must meet the general eligibility requirements set forth in § 2501 and be: (a) An individual or family that is chronically homeless as defined in Section 2(6C) of …

2572 TAH – APPLICATION FOR LRSP RENTAL SUBSIDY 2572.1 Assignment to a TAH case manager does not guarantee receipt of an LRSP rental subsidy. The applicant will work with the assigned TAH case manager to complete an application for the LRSP rental subsidy. 2572.2 The TAH case mana…

2573 TAH – SUPPORTIVE SERVICES 2573.1 TAH is designed to assist clients who would otherwise qualify for Permanent Supporting Housing pursuant to DCMR §§ 2535-2542 but do not require ongoing, intensive supportive services to maintain housing because they have fewer barriers to hou…

2574 REIMBURSEMENT FOR PSH SUPPORTIVE SERVICES 2574.1 The Department shall reimburse PSH providers, using per member per month (PMPM) rate structure, for the provision of PSH services to adult participants that are not eligible for enrollment in the District’s Medicaid Housing Su…

2599 DEFINITIONS 2599.1 For the purposes of this chapter, the following terms shall have the meanings ascribed: Act – the Homeless Services Reform Act of 2005, effective October 22, 2005 (D.C. Law 16-35; D.C. Official Code §§ 4-751.01, et seq. (2008 Repl. & 2011 Supp.)). Adult –a…

2600 SCOPE 2600.1 This chapter establishes the requirements for the Burial Assistance Program (Program), which shall include: (a) The process for applying for burial assistance; (b) The eligibility criteria for burial assistance; (c) The benefit and payment levels for the Program…

2601 APPLICATION PROCESS 2601.1 Each applicant for burial assistance shall: (a) Submit a written application on a Department "Burial Assistance Application" form and be signed by a relative, preferably the next of kin; and (b) Establish that the deceased person is the person for …

2602 ELIGIBILITY CRITERIA 2602.1 In order to be eligible for burial assistance, the eligibility criteria set forth in this section shall be met. 2602.2 The deceased person shall be a person who was a resident of the District of Columbia immediately prior to his or her death. 2602…

2603 BENEFITS AVAILABLE FOR BURIAL AND CREMATION 2603.1 When a deceased person meets the eligibility criteria described in section 2602 and an application has been filed and approved as required under section 2601, one (1) of the following shall occur: (a) Eight hundred dollars (…

2604 APPEALS 2604.1 Each aggrieved applicant shall have the right to appeal a denial of burial or cremation assistance. 2604.2 An applicant shall have the right to request a fair hearing by giving a clear expression, oral or written, that he or she would like the opportunity to p…

2699 DEFINITIONS 2699.1 When used in this chapter, the following terms shall have the meanings ascribed: Department - the Department of Human Services. Director - the Director of the Department of Human Services. Spouse - the husband or wife of the deceased person. SOURCE: Final …

MEDICAID PHARMACY SERVICES GENERAL PROVISIONS 2700.1 The District of Columbia Medicaid Program shall provide reimbursement for covered outpatient drugs dispensed by a licensed provider within the scope of his or her license and practice in accordance with federal, District, and s…

2701 PROVIDER PARTICIPATION 2701.1 A provider of pharmacy services shall be a licensed pharmacy. To participate in the District of Columbia’s Medicaid Program, the provider shall: Fully comply with any applicable District, state and federal laws or regulations governing the provi…

2702 PROFESSIONAL DISPENSING FEE 2702.1 Medicaid reimbursement of covered outpatient drugs to fee for service pharmacies shall include a professional dispensing fee. A professional dispensing fee is a fee that: (a) Is incurred at the point of sale or service; (b) Pays for pharmac…

2703 REIMBURSEMENT FOR PRESCRIPTIONS 2703.1 The District of Columbia Medicaid Program shall reimburse claims submitted by participating providers for the following prescriptions: Legend drugs that are approved for safety and effectiveness as prescription drugs by the U.S. Food an…

2704 BRAND NAME DRUGS 2704.1 A prescription drug written under its brand or trade name shall be filled with its generic equivalent when one is commercially available unless: (a) The prescriber has indicated that the brand name drug is medically necessary for the beneficiary by wr…

2705 THREE (3) DAY TEMPORARY SUPPLY 2705.1 If the prescription claim is rejected by Medicaid, due to a Prior Authorization requirement, and is otherwise valid, the provider shall provide the beneficiary with a three (3) day temporary supply, unless one (1) of the following except…

2706 LIMITATIONS AND REQUIREMENTS FOR CERTAIN SERVICES 2706.1 All claims submitted by participating providers shall only be reimbursed if they meet relevant quantity/day supply and refill limitations established by DHCF and are available in the on-line provider manual at HYPERLIN…

2707 REQUIREMENTS FOR RETURNED TO STOCK PRESCRIPTIONS 2707.1 All new and refilled prescriptions that have been filled for Medicaid beneficiaries but not picked up from the pharmacy within fourteen (14) days from the date of fill shall be returned to stock by the provider. The cla…

2708 REIMBURSEMENT FOR MULTIPLE SOURCE DRUGS 2708.1 A multiple source drug is a covered outpatient drug for which there is at least one other drug product that is: (a) Rated as therapeutically equivalent as reported in the FDA's “Approved Drug Products with Therapeutic Equivalenc…

2709 REIMBURSEMENT FOR BRAND NAME DRUGS 2709.1 Reimbursement for brand name drugs shall include a professional dispensing fee in the amount of $11.15 and the lesser of: The pharmacies’ usual and customary charges to the general public; or The Actual Acquisition Cost (AAC), which …

2710 CLAIMS REIMBURSEMENT REQUIREMENTS FOR PHARMACIES 2710.1 Reimbursement by the Department shall be restricted to only those drugs supplied from manufacturers that have a signed a national rebate agreement or an approved existing agreement, as specified in § 1927(a) of Title XI…

2711 [RESERVED] SOURCE: Final Rulemaking published at 59 DCR 2298, 2300 (March 23, 2012); as amended by Final Rulemaking published at 65 DCR 7837 (July 27, 2018). District of Columbia Municipal Regulations Public Welfare 29 DCMR § 2711 AUTHORITY: DC-DCMR The Director of the Depar…

2712 PHARMACY LOCK-IN PROGRAM 2712.1 The Department of Health Care Finance (DHCF) shall implement the Pharmacy Lock-In Program established by this section to safeguard against the following types of misuse of medications by beneficiaries enrolled in the District of Columbia Medic…

2713 EVALUATION OF SERVICE UTILIZATION 2713.1 Evaluation of utilization patterns may include, but are not limited to, review by the Department staff of electronic or paper records of claims submitted for prescriptions to assure compliance with the following: All prescription and …

2714 DRUG UTILIZATION REVIEW BOARD (DUR BOARD) 2714.1 Pursuant to the requirements of 42 C.F.R. part 456, subpart K, the District of Columbia has established the Drug Utilization Review Board (“DUR Board”) at DHCF. 2714.2 The DUR Board’s mission and mandate is to establish report…

2715 [REPEALED] SOURCE: Final Rulemaking published a 67 DCR 6826 (June 5, 2020); as amended by Final Rulemaking published at 69 DCR 015547 (December 30, 2022); as amended by Final Rulemaking published at 70 DCR 011626 (September 1, 2023). District of Columbia Municipal Regulation…

2716 MEDICATION THERAPY MANAGEMENT 2716.1 Medication Therapy Management (MTM) services are services provided by a pharmacist to a beneficiary to optimize the therapeutic outcomes for that beneficiary. MTM is a patient-centered service that assesses a patient’s entire drug regimen…

2799 DEFINITIONS 2799.1 For the purposes of this chapter, the following terms shall have the meanings ascribed: 340B Covered Entity Pharmacy - An in-house pharmacy of an entity that meets the requirements set forth in § 340B(a)(4) of the Public Health Services Act. 340B Contract …

2800 GENERAL REQUIREMENTS 2800.1 This chapter implements the District of Columbia Vital Records Act of 1981, D.C. Law 4-34, D.C. Code, 2001 Ed. § 7-201 to 7-228. 2800.2 This chapter shall be interpreted and applied consistent with and to facilitate the purpose of the Act. 2800.3 …

2801 PROCEDURES, FORMS AND REGISTRATION, GENERAL STATUTE REQUIREMENTS 2801.1 Each form, certificate, and report constituting the system of vital records shall be filed and registered with the Registrar. Vital records are considered to be registered only upon acceptance of the doc…

2802 INFANTS OF UNKNOWN PARENTAGE: FOUNDLING REGISTRATION 2802.1 The report for an infant of unknown parentage shall be registered on a foundling certificate by the person who initially assumes responsibility for the infant. A brief statement shall be provided on the certificate …

2803 DELAYED REGISTRATION OF BIRTH: GENERAL 2803.1 Each certificate of birth filed after five (5) days, but within one (1) year from the date of birth, shall be registered on the standard form of live birth certificate in the manner prescribed by D.C. Code, 2001 Ed. § 7-207. The …

2804 DELAYED REGISTRATION OF BIRTH: DOCUMENTARY EVIDENCE REQUIREMENTS 2804.1 A delayed certificate of birth shall be acceptable for filing if the name of the registrant and the date and place of birth to be entered on the document are supported as follows: (a) By two (2) pieces o…

2805 DELAYED REGISTRATION OF BIRTH: ACCEPTABILITY OF DOCUMENTARY EVIDENCE 2805.1 Each document presented for purposes of § 2804.1 such as a census, hospital, church, or school record, shall be from independent sources and shall be the original record, a duly certified copy, or a …

2806 DELAYED REGISTRATION OF BIRTH: ABSTRACTION OF DOCUMENTARY EVIDENCE 2806.1 The Registrar shall abstract on the delayed certificate of birth a description of each document submitted to support the facts shown on the delayed birth certificate, which shall include the following:…

2807 DELAYED REGISTRATION OF BIRTH CERTIFICATION AND ISSUANCE 2807.1 If the Registrar approves an application for registration of a delayed birth certificate, he or she shall, by signature, certify the following: (a) That no prior birth certificate is on file for the person whose…

2808 DELAYED REGISTRATION OF BIRTH: DISMISSAL OF APPLICATION 2808.1 Each application for a delayed certificate which has not been completed within one (1) year from the date of application may be dismissed at the discretion of the Registrar. 2808.2 Upon dismissal, the Registrar s…

2809 NEW CERTIFICATES OF BIRTH FOLLOWING ADOPTION, INTERMARRIAGE, PARENTAGE DETERMINATION, OR PARENTAGE ACKNOWLEDGMENT 2809.1 A new certificate of birth for a person who is adopted shall be prepared and registered in accordance with D.C. Official Code § 16-314. 2809.2 The content…

2810 DEATH REGISTRATION 2810.1 The funeral director or person acting as such who first takes custody of the dead body shall file a certificate of death. He or she shall obtain the personal data from the next of kin or the best qualified person or source available and obtain the m…

2811 DELAYED FILING AND REGISTRATION OF DEATH 2811.1 A certificate of death filed after the time prescribed in D.C. Official Code § 7-211 shall be on the certificate of death form, marked "delayed" and completed in the following manner: (a) If the attending physician or other per…

2812 DISPOSITION OF REPORTS OF FETAL DEATHS 2812.1 Reports of fetal death, required to be filed pursuant to D.C. Official Code § 7-213(a), are statistical reports that shall only be used for medical and health purposes and shall not be incorporated into the permanent official rec…

2813 AUTHORIZATION FOR DISINTERMENT AND REINTERMENT 2813.1 An authorization for disinterment and reinterment of a dead body shall be issued by the Registrar upon receipt of an application which meets the requirements of § 2813.2 or upon receipt of an order of a D.C. Court directi…

2814 MASS DISINTERMENT 2814.1 No mass disinterment shall be performed without the written authorization of the Registrar upon written application of the person requesting the mass disinterment. 2814.2 The Registrar shall not authorize a mass disinterment unless he or she receives…

2815 AUTHORIZATION FOR CREMATION 2815.1 Authorization for cremation of a decedent shall be obtained from the next of kin and the Chief Medical Examiner. 2815.2 The Registrar has no jurisdiction over disposal of the ashes of a deceased person. SOURCE: Final Rulemaking published at…

2816 DELAYED REGISTRATION OF MARRIAGE 2816.1 A marriage record may be filed after the time prescribed in D.C. Official Code § 7-215 on the regular marriage record form in the manner stated in this section. 2816.2 To be approved for registration by the Registrar, each delayed marr…