D.C. Mun. Regs. tit. 29, r. 29-5404
The Department shall not make any payment for Medicaid services to a fee-for-service primary care provider unless the provider has executed a Medicaid managed care provider agreement.
Each fee-for-service primary care provider's Medicaid managed care provider agreement with the Department shall be for a twelve (12) month period.
Each fee-for-service primary care provider shall be paid by the Department a fee-for-service for the covered services it provides to AFDC and AFDC-related Medicaid enrollees. The fees paid shall be the standard rate for the same service by the District's Medicaid program.
No fee-for-service primary care provider shall impose co-payment requirements or other fees that are not a part of the D.C. Medicaid Managed Care program on AFDC and AFDC-Related Medicaid enrollees.
If an enrollee loses Medicaid eligibility the Department shall not reimburse the fee-for-service primary care provider for any service rendered to that enrollee after the effective date of the termination of her/his eligibility.
If an enrollee voluntarily elects to change providers or is involuntarily assigned to another provider in accordance with the requirements of the program, the Department shall not reimburse the fee-for-service primary care provider from whose patient load the enrollee was reassigned for any service rendered to that enrollee after the effective date of the reassignment.
If an enrollee receives a service covered by the D.C. Medicaid Managed Care program from a provider other than her/his primary care provider of record, the Department shall not reimburse the provider rendering the service unless the service was authorized by the primary care provider in accordance with the requirements of the program.
D.C. Mun. Regs. tit. 29, r. 29-5404