District of Columbia Code Division I. Government of District. § 7-2071. Establishment of the Health Care and Public Benefits Ombudsman.

(b)(1) The Ombudsman Program shall be administered by the Health Care and Public Benefits Ombudsman, who shall be appointed by the Deputy Mayor of Health and Human Services, and who shall be an individual with management experience and substantive experience in the fields of health care, health benefits plans, health care advocacy, or public benefits program and advocacy.

(2) Unless DHCF is operating the program, the Health Care and Public Benefits Ombudsman shall be an employee of the nonprofit corporation, organization, or consortia of organizations selected by DHCF to operate the program.

(1) A public interest mission;

(2) Qualified staff and organizational expertise in health care and health benefits plans, public education and community outreach, and problem resolution;

(3) No direct involvement in the licensing, certification, or accreditation of a health care facility, a health benefits plan, or a provider of a health benefits plan, or with a provider of a health care service;

(4) No direct ownership or investment interest in a health care facility, health benefits plan, or any health service;

(5) No participation in the management of a health care service, health care facility, or health benefits plan;  and

(6) No agreement or arrangement with an owner or operator of a health care service, health care facility, or health benefits plan that could indirectly or directly result in remuneration, in cash or in kind, to the organization.

(1) Have a board of directors with significant representation from District consumers;

(2) Have experience in serving District residents or have staff with experience in serving District residents;  or

(3) Have expertise in health benefits plans.