For the purposes of this chapter, the term:
(1) “Accessible” means providing:
(A) The program's written materials in Spanish and English, and in other languages when required by Title VI of the Civil Rights Act of 1964, approved July 2, 1964 (78 Stat. 252; 42 U.S.C. § 2000d et seq.) (“Title VI”), or District law;
(B) Interpreters to communicate with consumers in Spanish, and in other languages when required by Title VI or District law; and
(C) TTY services and other accommodations for individuals with disabilities in accordance with the Americans with Disabilities Act of 1990, approved July 26, 1990 (104 Stat. 327; 42 U.S.C. § 12101 et seq.).
(2) “Consumer” means:
(A) An uninsured resident of the District, including residents enrolled in the HealthCare Alliance; or
(B) An individual covered by a health benefits plan in the District.
(3) “Department” means the Department of Health.
(4) “District” means the District of Columbia.
(5) “Health benefits plan” means a group or individual insurance policy or contract, medical or hospital service agreement, membership or subscription contract, or similar group arrangement provided by an insurer, or subcontracting facility of an insurer, or an employer for the purpose of providing, paying for, or reimbursing expenses for health-related services. The term “health benefits plan” shall include health coverage provided through a government program, including Medicaid. The term “health benefits plan” shall not include disability income or accident-only insurance.
(6) “Health Care Ombudsman” or “Ombudsman” means the individual responsible for running the Health Care Ombudsman Program.
(7) “Health Care Ombudsman Program” or “Ombudsman Program” means the program established by the District to counsel and assist uninsured District residents and individuals insured by health benefits plans in the District regarding matters pertaining to their health care coverage.
(8) “Health care services” means items or services provided under the supervision of a physician or other person trained or licensed to render health care necessary for the prevention, care, diagnosis, or treatment of human disease, pain, injury, deformity, or other physical or mental condition, including the following: pre-admission, outpatient, inpatient, and post-discharge care; home care; physician's care; nursing care; medical care provided by interns or residents in training; other paramedical care; ambulance service and care; bed and board; drugs; supplies; appliances; equipment; laboratory services; any form of diagnostic imaging or therapeutic radiological services; and services mandated under Chapter 31 of Title 31.
CREDIT(S)
(Apr. 12, 2005, D.C. Law 15-331, § 2, 52 DCR 1981.)
HISTORICAL AND STATUTORY NOTES
Legislative History of Laws
Law 15-331, the “Health Care Ombudsman Program Establishment Act of 2004”, was introduced in Council and assigned Bill No. 15-137 which was referred to the Committee on Finance and Revenue and the Committee on Human Services. The Bill was adopted on first and second readings on December 7, 2004, and December 21, 2004, respectively. Signed by the Mayor on January 19, 2005, it was assigned Act No. 15-740 and transmitted to both Houses of Congress for its review. D.C. Law 15-331 became effective on April 12, 2005.