Mayor Announces Improvements to the

Today, Mayor Adrian M. Fenty and The Department of Health (DOH) Interim Director Carlos Cano released an improvement plan aimed at strengthening eligibility verification for Alliance applicants.  The DC HealthCare Alliance (Alliance) is the District’s healthcare program for uninsured residents.  

The Alliance provides tens of thousands of District residents, who otherwise would be uninsured, access to vital healthcare services.  Participation in the Alliance requires that applicants are District residents with household incomes at or below 200 percent of the federal poverty level.

Last year, DOH requested that an independent audit be conducted to analyze the program.  In its audit, Bert Smith & Company revealed that there were areas of potential risk that could result in non-DC residents obtaining services.  As a result, DOH has been working with the Department of Human Services’ Income Maintenance Administration (IMA), the government entity responsible for eligibility verification for the Alliance and a host of other public assistance programs, to create an improvement plan that would ensure greater integrity in the program.

“I am pleased that IMA and DOH are jointly working to further improve the performance of eligibility verification so that our residents get the services they need,” said Mayor Fenty.  “The District has made great strides in reducing barriers for enrollment for these populations and will continue to maintain our promise to provide healthcare services to all District residents.”

The Performance Improvement Plan is organized into three major components:
1.    Enhanced Eligibility Verification Procedures
2.    Universal Quality Assurance Measures
3.    Risk-Based Quality Assurance Measures

DOH and IMA will utilize an array of tactics to ensure proper enrollment including, reviewing records for application du