District of Columbia, Department of Health Care Finance

D.C. Medicaid

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Contact

Phone
800-251-8890
Hours
Monday–Friday, 8 a.m.–5 p.m. ET

All contact options

Overview

Comagine Health provides a broad range of services for the District of Columbia, Department of Health Care Finance (D.C. Medicaid).

JUL 7, 2026

Comagine Health Provider Portal Training for Eyewear and Contacts

Comagine Health is updating the process for submitting prior authorization requests for eyewear and contacts on behalf of the District of Columbia, Department of Healthcare and Finance. In an effort to make the approval process more efficient, we are adding an auto-approval pathway for eyewear and contacts prior authorization requests through our Comagine Health Provider Portal (CHPP). This process change will start on August 3, 2026. In advance of this change, Comagine Health is hosting a training webinar for providers on July 28, 2026, at 9:00 AM ET.

This training webinar will provide an overview of:

  • How to log into the CHPP
  • The updated process to submit a prior authorization request through the CHPP for eyewear or contacts
  • Required documentation for submission

Registration for this training is required. Please register now.

MAY 8, 2026

Due to the recent transition of the MMIS, we are experiencing a prior authorization transfer issue with Gainwell regarding eligibility end dates. This is a known issue and is being addressed. In the interim, please continue to submit prior authorization requests without adjusting the request end dates to align with the eligibility end date. Prior authorizations that are impacted by this issue are being tracked, and once the issue is resolved, Comagine Health will ensure that missing prior authorizations are in MMIS. If there are questions, please enter a Web Note in the submission episode in the Provider Portal and Comagine Health will respond promptly.

MAR 31, 2026

Starting May 4, 2026, prior authorization requests for acute care hospital services associated with surgical procedures, transplants, medical procedures, and testing will be submitted differently through the Comagine Health Provider Portal (CHPP). This training webinar will provide an overview of:

  • The changes to the submission of prior authorization requests for Acute Care Hospital through the CHPP
  • How to log in and enter to submit a prior authorization request for Acute Care Hospital through the CHPP
  • Required documentation

The training webinar will take place April 29, 2026, at 11:00 a.m. to 12:00 p.m. ET. Registration is required to attend the training; please register now.

Earlier announcements (4)

MAR 9, 2026

The Department of Health Care Finance (DHCF) transitioned its Medicaid Management Information System (MMIS) from Conduent to Gainwell Technologies. The new system launched on March 2, 2026. If you are experiencing delays with prior authorizations appearing in the new MMIS please log into the Comagine Health Provider Portal and place a web note in the episode with the delay. We will provide a response within 78 business hours.

JUL 3, 2025

The District of Columbia Department of Behavioral Health (DBH) in collaboration with the Department of Healthcare Finance (DHCF) will transition Crisis Bed Stabilization prior authorization reviews to Comagine Health. Effective August 18, 2025, DBH-certified providers will need to submit requests for Initial and Continued Crisis Bed Stabilization stay reviews to Comagine Health. The prior authorization requests will be reviewed and decisioned based on medical necessity criteria developed by the DBH, as well as all relevant local and federal regulations. Providers were notified of the upcoming transition of prior authorization reviews to Comagine Health beginning with Crisis Beds on March 20, 2025 by DBH.

MAY 17, 2023

Going live June 5: Your Comagine Health Provider Portal is getting an upgrade! The new system looks different and features enhanced functionality, such as a Provider Dashboard where you can track requests after submission.

The current provider portal will shut down close of business (5:00 p.m.) on June 2 through the morning of June 5.

Please check this page regularly for updates about provider training and resources.

Our regional office in the District is staffed by people who live in and around the District and whose work helps improve and advance the efficiency, economy, effectiveness and quality of health care services provided to enrolled District of Columbia Medicaid beneficiaries.

Services we provide for D.C. Medicaid

  • Utilization management
    • Prior authorization review
    • Pre-admission review
    • Direct acute inpatient admission review
    • Continued stay review
    • Retrospective review
    • Long-term care review
  • Child and Adolescent Supplemental Security Income Program (CASSIP) review
  • Substance use disorder/residential treatment facilities review

CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F)