Title 7 — Human Health Care and Safety.

For the purposes of this chapter, the term: (1) “Accessible” means providing: (A) The program’s written materials in Spanish and English, and in other languages when required by Title VI of the Civil Rights Act of 1964, approved July 2, 1964 (78 Stat. 252; 42 U.S.C. § 2000d et se…

(a) The Department shall establish the Health Care Ombudsman Program by contracting with a qualified private, community-based, nonprofit corporation, organization, or consortia of organizations, with offices located in the District, to operate the program. If the Department is un…

(a) The Department shall develop criteria to be used in evaluating the performance of the Ombudsman Program. (b)(1) The Department shall obtain, biannually, an independent evaluation of the Ombudsman Program through an academic group or other independent, private-sector organizat…

The Ombudsman Program shall provide the following accessible services: (1) Assist consumers in resolving problems concerning health care bills, health coverage, and access to health care by referring consumers to appropriate regulatory agencies when their problems are within an a…

The Ombudsman Program shall implement innovative strategies and tools to maximize its outreach to consumers, including provision of the following accessible information sources and services: (1) A toll-free 1-800 telephone number that operates in the District metropolitan area; (…

The Health Care Ombudsman shall submit annually to the Council, the Mayor, the Department of Health, and the Department of Insurance, Securities, and Banking a report on the activities, performance, and fiscal accounts of the Ombudsman Program, issues of concern to consumers, and…

(a) The Health Care Ombudsman may review the records of a health benefits plan, the HealthCare Alliance, or other provider, pertaining to a consumer or the consumer’s medical records if the consumer or the consumer’s legal representative has provided written consent. The confiden…

No employee, subcontractor, designee, or representative of the Ombudsman Program shall be held liable for the good faith performance of responsibilities under this chapter, except that no immunity shall extend to criminal acts, or acts that violate District or federal law.

A health benefits plan or the HealthCare Alliance shall not take retaliatory action of any sort against a member who seeks assistance from the Ombudsman Program or against a provider who furnishes information to the Ombudsman Program pursuant to a consumer’s request.

(a) Health benefits plans and the HealthCare Alliance shall: (1) Include in their marketing and membership materials information regarding the availability of the Ombudsman Program; (2) Send annually to their members notification of the availability of the Ombudsman Program; and …

(a) The Ombudsman shall establish an Advisory Council to consist of members representing: (1) Consumers; (2) Consumer advocacy organizations; (3) Health benefits plans; (4) Health care facilities; (5) Physicians; (6) The Health Insurance Counseling and Assistance Program or any s…

(a) Funding sources for the Ombudsman Program shall include: (1) District local appropriations; and (2) Medicaid federal matching funds. (b) Nothing in this chapter shall prohibit a corporation, organization, or consortia of organizations selected to operate the Health Care Ombud…

Repealed Repealed.