D.C. Mun. Regs. tit. 26, r. 26-A3513
An HMO may include in its individual contract a provision setting forth reasonable exclusions or limitations of services for preexisting conditions at time of enrollment. However, no such exclusions or limitations shall be for a period greater than twelve (12) months for enrollees or eighteen (18) months for late enrollees.
No HMO shall exclude or limit services for a preexisting condition when the enrollee transfers coverage from one individual contract to another or when the enrollee converts coverage under his conversion option, except to the extent of a preexisting condition limitation or exclusion remaining unexpired under the prior contract. Any required probationary or waiting period shall be deemed to have commenced on the effective date of coverage under the prior contract. The HMO contract shall disclose any preexisting condition limitations or exclusions that are applicable when an enrollee transfers from a prior HMO contract.
No HMO shall discriminate against any enrollee or applicant seeking enrollment for reasons other than that of the enrollee's or applicant's own merit. This includes, but is not limited to, discrimination by reason of race, color, religion, national origin, sex, age, marital status, personal appearance, sexual orientation, family responsibilities, matriculation, political affiliation, disability, source of income and place of residence or business, or because of the frequency of utilizatiion of services by an enrollee. Further, nothing shall prohibit an HMO from setting rates or establishing a schedule of charges in accordance with relevant actuarial data.
No HMO shall expel or refuse to re-enroll any enrollee nor refuse to enroll individual members of a group on the basis of the health status or health care needs of the individuals or enrollees.
D.C. Mun. Regs. tit. 26, r. 26-A3513