D.C. Mun. Regs. tit. 29, r. 29-4708
An interim rate shall be developed for reimbursement of TCM services based on unaudited costs as reported by CFSA. The final rate paid to CFSA shall not exceed the actual cost incurred by CFSA in providing services to the target population.
The interim rate shall be $ 646.00 per month for each client receiving TCM services.
If, after an audit, an adjustment is made to CFSA's reported costs, all claims paid during the audit period shall be adjusted to conform with the actual cost of CFSA providing services to the target population.
CFSA shall agree to accept as payment in full the amount determined by MAA as reimbursement for authorized services provided to clients. Providers shall not bill the client or any member of the client's family for TCM services.
CFSA shall bill any and all known third-party payors prior to billing the Medicaid Program.
CFSA shall be responsible for paying the District's share or the local match of Medicaid Federal Financial Participation attributable to TCM services provided by CFSA or its subcontractors. CFSA shall certify, on an annual basis, that it has expended non-federal public funds in an amount equal to the District's share. The annual certification shall be made in writing in a manner prescribed by the Department of Health.
D.C. Mun. Regs. tit. 29, r. 29-4708