DC Department of Health Care Finance CGT Access Model - The District of Columbia State Medicaid Agency, The Department of Health Care Finance (DHCF), seeks funding through opportunity number CMS-2P2-25-001 “Cell and Gene Therapy (CGT) Access Model” to support District implementation of the CGT Access Model and improve and access to cell and gene therapy for sickle cell disease patients, and support their care journey and outcomes. CMS introduced the CGT access model in 2023, which tests the question of whether CMS negotiated outcomes based agreements will allow facilitate reduced prices and increased outcomes for individuals with sickle cell disease. In recognition of the burden of required implementation activities and the opportunity to support increased access and improved outcomes for individuals on therapy, CMS has provided this grant opportunity in conjunction with the model test. The CMMI grant funds will support DHCF in: 1. Building the internal agency capacity to participate fully in the CGT access model and meet all participation requirements fully. 2. Providing direct support for patients and their families as they engage in the care delivery journey for new groundbreaking therapies for sickle cell disease; and 3. Increase community awareness and engagement across the sickle cell disease community and providers to support increased access to cell and gene therapy and improvement across the care journey The District is requesting $7,072,261 over the ten (10) year performance period of the grant. The funding be used to add a staff position, support model implementation activities, and provide direct support to individuals eligible for sickle cell disease gene therapy. This support will allow the District to achieve the above-mentioned goals, participate in the national model test, and ultimately improve outcomes for sickle cell disease patients and their families in the District.
