Overview

The District of Columbia was relatively inactive in the 2019 legislative term. The legislature passed B23-0101/PR23-0086 which provides that the State Health Planning and Development Agency has the authority to approve the closure or termination of a health care facility. Other bills regarding certificate of need and unfair trade practices are still pending in the legislature.

In the 2017-2018 legislative term, the District of Columbia legislature enacted several laws to expand healthcare markets, including laws concerning the scope of practice of healthcare providers. Most notably, the legislature passed the Telehealth Medicaid Expansion Act of 2017, which expands the scope of reimbursable telehealth services covered by Medicaid.

The State Database

The Source tracks state activities impacting healthcare price and competition in both legislation and litigation in a searchable database to help stakeholders at the state level understand their legal and regulatory environment as they make efforts to improve access, quality, and efficiency, and reduce costs in healthcare.

LEGISLATION: The Database of State Laws Impacting Healthcare Cost and Quality (SLIHCQ), created by The Source on Healthcare Price & Competition and Catalyst for Payment Reform, catalogues state legislation governing price transparency, provider market power, provider payment, provider networks, and benefit design. The database also includes pharmaceutical legislation beginning in the 2017-2018 legislative session. *Note: Current legislative session bill updates are ongoing. Check back weekly for updates.

LITIGATION: The Source tracks major litigation and antitrust enforcement action by federal entities (FTC or DOJ), state attorney generals, and private parties in the main provider and insurer markets, particularly legal challenges of healthcare consolidation and anticompetitive contract provisions. Additionally, the database contains major pharmaceutical cases including legislation challenges and significant appellate cases.

Search the database across all jurisdictions on the State Overview page, or view and filter existing legislation or litigation on individual state pages. The database allows customized search and filter by keyword, status, and/or key issue category. *Multiple filter/selections enabled. Click here for User Guide.

Recent Legislation

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B2-0558 – District of Columbia
Introduced: 2017 Status: Inactive / Dead
This bill requires health care facilities to add community benefits – health improvement services and benefits that are provided without charge – as a prerequisite to obtaining or maintaining a certificate of need. The community …

B22-0106 – District of Columbia
Introduced: 2017 Status: Enacted
This legislation allows licensed pharmacy practitioners to prescribe and dispense self-administered hormonal contraceptives and also requires insurers to cover certain health care services without cost-sharing, including breast cancer screening and counseling, screening for HIV and …

B22-0233 – District of Columbia
Introduced: 2017 Status: Enacted
Telehealth Medicaid Expansion Act of 2017: To amend the Telehealth Reimbursement Act of 2013 to expand the scope of reimbursable telehealth services covered by Medicaid, to clarify that all categories of Medicaid recipients are eligible …

B22-0233 – District of Columbia
Introduced: 2017 Status: Enacted
As introduced, this bill establishes what reimbursement codes a telehealth provider must utilize to be eligible for reimbursement. It establishes the criteria and protocols that must be in place for remote patient monitoring services eligibility …

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Enacted Laws

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B22-0405 – District of Columbia
Introduced: 2017 Status: Enacted
Law 22-176 establishes the maximum fee of $5,000 for filing a certificate of need application by a federally qualified health center for projects located in Wards 7 and 8.

B22-0690 – District of Columbia
Introduced: 2018 Status: Enacted
As introduced, this bill requires the Department of Health to conduct a study to evaluate availability of affordable long-term care facilities, services and supports for residents of the District of Columbia. Among other things the …

B22-1001 – District of Columbia
Introduced: 2018 Status: Enacted
Health Insurance Marketplace Improvement Act Of 2018

B22-1020 – District of Columbia
Introduced: 2018 Status: Enacted
Health Insurance Marketplace Improvement Emergency Amendment Act Of 2018

B22-1021 – District of Columbia
Introduced: 2018 Status: Enacted
Health Insurance Marketplace Improvement Temporary Amendment Act Of 2018

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Key Litigation

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In re: Suboxone Antitrust Litigation (State of Wisconsin, et al. v. Indivior Inc, et al.) – Alabama, Alaska, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, Utah, Virginia, Washington, West Virginia, Wisconsin
District Court: E.D. Pennsylvania Status: Pending
In September 2016, 35 state attorneys general and the District of Columbia brought a multi-district case against pharmaceutical manufacturer Indivior, MonoSol RX et al., alleging …

In Re: Generic Pharmaceuticals Pricing Antitrust Litigation – Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin
District Court: Eastern District of Pennsylvania Status: Pending
Plaintiffs are attorney generals from 48 states, Puerto Rico, and the District of Columbia, as well as classes of private plaintiffs that filed an antitrust …

United States et al. v. Anthem, Inc., and Cigna Corp. – California, Colorado, Connecticut, District of Columbia, Federal, Georgia, Iowa, Maine, Maryland, New Hampshire, New York, Tennessee, Virginia
District Court: District of Columbia Status: Decided
On April 28, 2017, the Second Circuit affirmed the District Court’s decision to block the proposed $54 billion merger between Anthem and Cigna, siding with …

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Additional Resources

LEGISLATIVE CALENDAR

The District of Columbia’s current legislative session runs from 1/2/2019 – 1/2/2020. Bills from 2019 will carry over to 2020 as part of the 2019-2020 legislative term.

FY 2020 BUDGET

Washington D.C. budgets on a biennium basis with the Executive biennium budget submitted to the Legislature on or before December 20^th. The legislature adopts a budget in either April or May and the biennial budget cycle begins in July. See Washington D.C.’s Department of Health budget for the fiscal year 2020 on page E-53 here.