If an Alliance beneficiary becomes an inmate, the Department shall suspend capitation payments to the MCO in which the Alliance beneficiary is enrolled for the duration of the Alliance beneficiary's incarceration. Alliance program participation and capitation payments for an Alliance beneficiary can be initiated on the date of release from the correctional institution.
Inmate shall mean an individual in custody and held involuntarily through operation of law enforcement authorities in a correctional institution, which includes facilities operated by, or under contract with, the United States, a state, a territory, a political subdivision of a state or territory, or an American Indian/Alaska Native tribe for the confinement or rehabilitation of persons charged with or convicted of a criminal offense or other persons held involuntarily in lawful custody through operation of law enforcement authorities (e.g., state or federal prisons, local jails, detention facilities, or other penal settings such as boot camps and wilderness camps).
An individual is not considered an inmate if the individual resides in a child care institution, publicly operated community residence that serves no more than sixteen (16) residents, a public educational or vocational training institution, or a halfway house.
D.C. Mun. Regs. tit. 22, r. 22-B3306