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
New DC Health Regs Require Boosters By March 1
New DC Health emergency regulations published February 8 updated the COVID vaccine requirements for healthcare workers to include boosters. All healthcare workers must be in compliance by March 1.
The emergency regulation, seen here, updates the previous requirement that licensed healthcare workers must be vaccinated to practice in the District. That requirement began last fall, with MSDC providing advocacy and support on behalf of its membership. That requirement is now updated such that full vaccination requires all recommended vaccine doses as listed by the CDC.
The timeline for compliance in the emergency regulation is March 1, less than three weeks after the publication date of the rule. There is no language allowing for extensions. MSDC is concerned with the tight deadline - even though it supports up-to-date vaccinations for healthcare workers - and is working on asking DC Health for an extension.
We will publish additional information as it becomes available but physician offices should prepare now to comply with this mandate prior to the March 1 deadline.
Updated information from DC Health
On August 27, 2021, regulations were issued requiring the following individuals receive the first dose of a COVID-19 mRNA vaccine (i.e., Moderna or Pfizer) or a single dose of the Johnson & Johnson vaccine no later than September 30, 2021:
• Health professionals who are licensed, registered, or certified by the Department of Health, and
• Unlicensed personnel in a Healthcare setting.
On February 8, 2022, an emergency rulemaking was adopted and effective immediately on that date. This rulemaking modifies sections 230 and 231 of Chapter 2 (Communicable and Reportable Diseases) of Subtitle B (Public Health and Medicine) of Title 22 (Health) of the DCMR to require health care workers to be up to date on their COVID-19 vaccine. This rulemaking, requires health professional and unlicensed personnel to be “up to date” on COVID-19 vaccines. At this time, this means:
(1) a primary series of:
(a) two shots of Pfizer or Moderna or (b) one Jansen/Johnson shot, and
(2) a booster shot by March 1, 2022.
The phrase “up to date” means a person has received all recommended COVID-19 vaccine doses, including any booster dose(s) and annual vaccine doses, when eligible for such doses, as set forth by the Centers for Disease Control and Prevention (CDC). A copy of the relevant regulations is attached.
To assist in this process, DC Health has created an online booster vaccine reporting portal which can be accessed by going to https://doh.force.com/ver/s/vaccinereporting. All licensed and unlicensed health care workers must report their vaccine status via this online tool. Individuals who meet the requirements for an exemption to the vaccine mandate will also be able to submit a request for an exemption via this portal. To obtain an exemption, individuals must meet one of the following requirements:
Failure to meet this requirement can result in disciplinary action including suspension and revocation of a health professional’s license.
For licensed and unlicensed personnel, no Healthcare facility, after, regardless of the date of hire, shall employ, contract, or grant privileges to a person who is not up to date.
Please follow the below instructions for requesting an exemption.
• For religious exemptions, individuals will need to upload a letter, stating that their vaccination against COVID-19 would violate a sincerely held religious belief and the vaccination would in fact violate a sincerely held religious belief of the person.
• For medical exemption requests, individuals will need to provide the name and license number of the healthcare provider who issued the medical exemption, and then upload a written letter from that licensed healthcare provider stating that being vaccinated against COVID-19 is medically inadvisable due to the person’s medical condition and it is in fact medically inadvisable for the person to receive a COVID-19 vaccine.
• For the World Health Organization (W.H.O.) exemption, individuals will need to upload proof of vaccination of a W.H.O. approved vaccine and provide dates of vaccination.
All exemptions must be reviewed and approved by DC Health. Please allow time for the review and approval process.
If you want a copy of your submission for your records, please print or take a screen shot before you hit the Submit button. You will receive an email thank you message.
Emergency and Proposed Rulemaking 2-8-2022 Mandatory COVID-19 Vaccination fo
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