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Managed Care Information

The Office of Managed Care monitors the performance of Managed Care Organizations (MCOs). In 1994, the District began a major effort to promote managed care. The Office of Managed care was formed and it seeks to facilitate objectives in the managed care arena that will comply with the Department of Health Care Finance's mission and goals of advancing health promotion by ensuring the contractual compliance and regulatory adherence by the participating health plans to all pertinent governing rules and laws. The Office of Managed Care monitors the participating health plans' obligation to provide appropriate, timely, and quality care to managed care eligible persons which includes TANF, TANF-related, immigrant children, 50-64 childless adults and SCHIP recipients. The Medicaid Managed Care program enrollment encompasses a majority of the total Medicaid Enrollment. The steady increase year-to-year of the managed care penetration in the Medicaid program serves to highlight the importance of the OMC. Today, 65% of Medicaid enrollees belong to one of four managed care plans. MCOs accept clinical and financial responsibility for a majority of Medicaid services provided to their members who are typically children and their non-disabled family members (newborn through 64 year of age).


Medicaid Managed Care Contacts:

AmeriHealth:(800) 408-7511
Health Services for Children with Special Needs:(866) 937-4549
MedStar Family Choice:(888) 404-3549
Trusted Health Plan: (202) 821-1100 (Main)

(855) 326-4831 (Toll free)

Enrollment Broker:

DC Healthy Families:(800) 620-7802