DYRS Reaches Major Milestone in Medicaid Reimbursement Implementation Efforts

(Washington, DC) - The Department of Youth Rehabilitation Services (DYRS) has achieved a significant advancement in its efforts to establish Medicaid reimbursement for eligible services provided to youth in its care.

In September 2026, the Centers for Medicare & Medicaid Services approved the District's 1115 Waiver, allowing DYRS to seek Medicaid reimbursement for eligible case management services provided to youth.

Additionally, DYRS received approval under the Consolidated Appropriations Act to seek Medicaid reimbursement for eligible medical and behavioral health services provided to youth at New Beginnings Youth Development Center during the 30 days prior to their release.

"This achievement reflects the strong collaboration between DYRS, the DC Department of Health Care Finance (DHCF), and our federal partners," said DYRS Director Sam Abed. "We appreciate the commitment and effort that have gone into reaching this point and look forward to continuing our work to ensure the Department is prepared for Medicaid reimbursement."

Under the current timeline:
• Beginning January 1, 2027, DYRS may begin submitting Medicaid reimbursement claims for eligible medical and behavioral health services.
• Beginning October 1, 2027, DYRS may begin submitting Medicaid reimbursement claims for eligible case management services.

Through a Memorandum of Understanding (MOU) with the District's DHCF, DYRS secured federal grant funding to support the agency's Medicaid reimbursement initiative. The agreement provides funding for a dedicated Medicaid staff position that is currently supporting implementation efforts, as well as enhancements to the Department's technology systems needed to support Medicaid billing and reporting requirements.

The agreement also includes funding to enhance FamCare, DYRS' case management system, and Fusion, the agency's medical software platform. These upgrades will enhance Medicaid billing functions, strengthen reporting capabilities, and improve overall system readiness.
DYRS and DHCF continue to meet regularly to finalize operational procedures, complete system enhancements, provide staff training, and prepare for Medicaid billing operations. This progress reflects years of planning and coordination among District and federal partners and represents a significant step forward in preparing the Department for Medicaid reimbursement.