I
MURIEL BOWSER
MAYOR
July 17, 2020
The Honorable Phil Mendelson
Chairman
Council of the District of Columbia
John A. Wilson Building
1350 Pennsylvania Avenue, NW, Suite 504
Washington, DC 20004
Dear Chairman Mendelson:
Pursuant to section 451 of the District of Columbia Home Rule Act (D.C. Official Code 1-204.51) and
the Procurement Practices Reform Act (D.C. Official Code 2-351.01 et seq.), enclosed for
consideration and approval by the Council of the District of Columbia is proposed contract CW83 l 46
with Trusted Health Plan (District of Columbia, Inc.), DBA CareFirst BlueCross BlueShield Community
Health Plan. The proposed contract is in the not-to-exceed amount of $1,492,392,346.13, the total
contract NTE amount for all three managed care organization contracts. The contract is for the period of
October 1, 2020 through September 30, 2021.
Under the proposed contract, Trusted Health Plan (District of Columbia, Inc.), DBA CareFirst BlueCross
BlueShield Community Health Plan, shall provide healthcare and pharmacy services for its Managed Care
Program. The Medicaid Managed Care Program consists of the DC Healthy Families Program, including
Adults with Special Health Care Needs, (adults receiving Supplemental Security-Income (SSI) and with
SSI-related disabilities), the District of Columbia Healthcare Alliance Program), and the Immigrant
Children's Program.
I am available to discuss any questions you have regarding the proposed contract. In order to facilitate a
response to any questions you may have, please have your staff contact Marc Scott, Chief Operating
Officer of the Office of Contracting and Procurement, at (202) 724-8759.
I look forward to the Council's favorable consideration of this contract.
Sincerely,
Enclosure
 GOVERNMENT OF THE DISTRICT OF COLUMBIA
Office of Contracting and Procurement
Pursuant to section 202(c) of the Procurement Practices Reform Act of 2010, as amended, D.C.
Official Code 2-352.02(c), the following contract summary is provided:
COUNCIL CONTRACT SUMMARY
(A) Contract Number: CW83146
Proposed Contractor: Trusted Health Plan (District of Columbia, Inc., DBA CareFirst BlueCross
BlueShield Community Health Plan (CareFirst)
Contract Amount (Base Year): Not-to-exceed (NTE) $1,492,392,346.13. The total contract NTE
amount is for all three Managed Care Organization (MCO) contracts.
Unit and Method of Compensation: Monthly capitation payment for each participant
Term of Contract: October 1, 2020 to September 30, 2021
Type of Contract: Indefinite Delivery/Indefinite Quantity (IDIQ) with fixed capitated rates.
Source Selection Method: Request for Proposal (RFP)
(B) For a contract containing option periods, the contract amount for the base period and for
each option period. If the contract amount for one or more of the option periods differs from
the amount for the base period, provide an explanation of the reason for the difference:
Base Period Amount: NTE $1,492,392,346.13
Option Period 1, Option Period 2, Option Period 3 and Option Period 4: Amount will be based
on actuarial review of the capitation rates. An adjustment to the capitation rates shall be effective as
of the first day of the option period and six months after each option period, to which the adjusted
capitation rate applies (either upwards or downwards), if appropriate. In the event a prospective
capitation rate adjustment is required, an actuarial analysis will be completed by the Districts
contracted actuary. If required, the District will make the necessary adjustment to the capitation
rates.
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(C) The goods or services to be provided, the methods of delivering goods or services, and any
significant program changes reflected in the proposed contract:
Contractors provide healthcare and pharmacy services for their Managed Care Program. The
Medicaid Managed Care Program (MMCP) consists of the DC Healthy Families Program
(DCHFP), including Adults with Special Health Care Needs, (adults receiving Supplemental
Security-Income (SSI) and with SSI-related disabilities), the District of Columbia Healthcare
Alliance Program (Alliance), and the Immigrant Childrens Program (ICP).
(D) The selection process, including the number of offerors, the evaluation criteria, and the
evaluation results, including price, technical or quality, and past performance components:
Solicitation Number Doc490243 was issued on January 10, 2020 and closed on February 20, 2020.
On the closing date, the District received seven proposals in response to solicitation. The seven
proposals were evaluated in accordance with the technical evaluation factors as described in the
solicitation, which are listed below.
The evaluation factors consisted of a total of 90 points in three categories.
Technical Approach and Methodology (20 Points)
Technical Expertise (50 Points)
Past Performance (20 Points)
The price proposal worth ten points was evaluated by the Contracting Officer (CO) using the
following formula:
Lowest price proposal
--------------------------------------- x 10 = Evaluated price score
Price of proposal being evaluated
The solicitation also provided for a maximum of 12 preference points allocated for certified
business enterprises.
Based upon the findings of the Technical Evaluation Panel and the Contracting Officers
independent review of the proposals in accordance with the evaluation factors, the Contracting
Officer determined that the proposals from AmeriHealth Caritas District of Columbia, Inc.
(AmeriHealth), CareFirst, and MedStar Family Choice (MedStar) were the most advantageous to
the District and recommended that award be made to AmeriHealth, CareFirst, and MedStar.
(E) A description of any bid protest related to the award of the contract, including whether the
protest was resolved through litigation, withdrawal of the protest by the protestor, or
voluntary corrective action by the District. Include the identity of the protestor, the grounds
alleged in the protest, and any deficiencies identified by the District as a result of the protest:
Protest 1: CAB No. P-1123, Protestor: District Community Care, Inc., Resolution: Protest
Pending
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 On June 4, 2020 a protest was filed by District Community Care, Inc. with the Contract Appeals
Board (CAB). The filed protest relates to the current solicitation Doc490243. District Community
Care, Inc alleges that the District deviated from the RFPs scoring rubric, the district applied
unstated evaluation criteria, the District applied unstated criteria in the evaluation of DCCs
staffing plan, and the District applied unstated evaluation criteria regarding the role of
DCCs affiliates.
As of July 13, 2020, this protest is pending before CAB.
(F) The background and qualifications of the proposed contractor, including its organization,
financial stability, personnel, and performance on past or current government or private
sector contracts with requirements similar to those of the proposed contract:
The Contractor is currently providing services to the satisfaction of the District under the current
contract, which expires on September 30, 2020. The Contractor has performed these services for the
District since 2013.
The proposed contractor has demonstrated through past performance reports that its organization
has the history, organizational and technical experience, including the key personnel, required to
successfully meet the requirements of the proposed contract. Likewise, it has been determined that
the proposed contractor maintains the financial resources, accounting and operational controls to
successfully fulfill the Districts requirement. The proposed contractor has been determined
responsible in accordance with the Districts Standards for Responsibility.
(G) A summary of the subcontracting plan required under section 2346 of the Small, Local, and
Disadvantaged Business Enterprise Development and Assistance Act of 2005, as amended,
D.C. Official Code 2-218.01 et seq. (Act), including a certification that the subcontracting
plan meets the minimum requirements of the Act and the dollar volume of the portion of the
contract to be subcontracted, expressed both in total dollars and as a percentage of the total
contract amount:
The contractor is certified as a local business enterprise, business located in an enterprise zone, and
resident business ownership. Therefore a subcontracting plan is not required. The Contracting
Officer has determined that the Contractor meets the DSLBD requirements.
(H) Performance standards and the expected outcome of the proposed contract:
The Department of Health Care Finance (DHCF) aims to align the structure, operations and
performance of managed care with the diverse range of preventive, acute and chronic health
diseases and conditions of District residents eligible for the DCHFP, Alliance, and ICP.
Perform is expected to be in accordance with all state and federal regulatory standards applicable to
Medicaid MCOs, including, but not limited to, Section C.5.1.1 of the contract and 42 C.F.R. 438
et seq.
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(I) The amount and date of any expenditure of funds by the District pursuant to the contract
prior to its submission to the Council for approval:
None
(J) A certification that the proposed contract is within the appropriated budget authority for the
agency for the fiscal year and is consistent with the financial plan and budget adopted in
accordance with D.C. Official Code 47-392.01 and 47-392.02:
The DHCF Agency Fiscal Officer certified that funding in the NTE amount of $1,492,392,346.13 is
available to DHCF to support the contract for the MCOs. The amount is for all three MCO
contracts.
(K) A certification that the contract is legally sufficient, including whether the proposed
contractor has any pending legal claims against the District:
The contract has been reviewed by the Office of the Attorney General and found to be legally
sufficient. The contractor has no pending legal claim against the District.
(L) A certification that Citywide Clean Hands database indicates that the proposed contractor is
current with its District taxes. If the Citywide Clean Hands Database indicates that the
proposed contractor is not current with its District taxes, either: (1) a certification that the
contractor has worked out and is current with a payment schedule approved by the District;
or (2) a certification that the contractor will be current with its District taxes after the District
recovers any outstanding debt as provided under D.C. Official Code 2-353.01(b):
On May 20, 2020, the Citywide Clean Hands database certified that the contractor is current with its
District taxes.
(M) A certification from the proposed contractor that it is current with its federal taxes, or has
worked out and is current with a payment schedule approved by the federal government:
The contractor has self-certified, via the Bidder/Offeror Certification form, that it is current with its
federal taxes.
(N) The status of the proposed contractor as a certified local, small, or disadvantaged business
enterprise as defined in the Small, Local, and Disadvantaged Business Enterprise
Development and Assistance Act of 2005, as amended; D.C. Official Code 2-218.01 et seq.:
The contractor is certified by DSLBD as a local business enterprise, business located in an
enterprise zone, and resident business ownership.
(O) Other aspects of the proposed contract that the Chief Procurement Officer considers
significant:
None
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(P) A statement indicating whether the proposed contractor is currently debarred from providing
services or goods to the District or federal government, the dates of the debarment, and the
reasons for debarment:
As of May 17, 2020, the Contractor does not appear on the Office of Inspector General Exclusions
Database, the Federal Excluded Parties List or the Districts list of Debarred and Suspended
Contractors.
(Q) Any determination and findings issues relating to the contracts formation, including any
determination and findings made under D.C. Official Code 2-352.05 (privatization
contracts):
D&F for Competitive Sealed Proposal
D&F for Competitive Range Determination
D&F for Contractors Responsibility
D&F for Price Reasonableness
(R) Where the contract, and any amendments or modifications, if executed, will be made
available online:
http://ocp.dc.gov
(S) Where the original solicitation, and any amendments or modifications, will be made available
online:
http://ocp.dc.gov
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 Government of the District of Columbia
Office of the Chief Financial Officer 1101 4th Street, SW
Office of Tax and Revenue Washington, DC 20024
Date of Notice: May 20, 2020 Notice Number: L0004100143
TRUSTED HEALTH PLAN (DISTRICT OF COLUMBIA), I FEIN: **-***5150
1100 NEW JERSEY AVE SE STE 840 Case ID: 476676
WASHINGTON DC 20003-3338
CERTIFICATE OF CLEAN HANDS
As reported in the Clean Hands system, the above referenced individual/entity has no outstanding
liability with the District of Columbia Office of Tax and Revenue or the Department of Employment
Services. As of the date above, the individual/entity has complied with DC Code 47-2862, therefore
this Certificate of Clean Hands is issued.
TITLE 47. TAXATION, LICENSING, PERMITS, ASSESSMENTS, AND FEES
CHAPTER 28 GENERAL LICENSE
SUBCHAPTER II. CLEAN HANDS BEFORE RECEIVING A LICENSE OR PERMIT
D.C. CODE 47-2862 (2006)
47-2862 PROHIBITION AGAINST ISSUANCE OF LICENSE OR PERMIT
Authorized By Marc Aronin
Chief, Collection Division
To validate this certificate, please visit MyTax.DC.gov. On the MyTax homepage, click Clean Hands
and then the Validate a Certificate of Clean Hands hyperlink.
1101 4th Street SW, Suite W270, Washington, DC 20024/Phone: (202) 724-5045/MyTax.DC.gov
 GOVERNMENT OF THE DISTRICT OF COLUMBIA
Department of Health Care Finance
Office of the Chief Financial Officer
MEMORANDUM
TO: George A. Schutter
Chief Procurement Officer
Office of Contracting and Procurement
THRU: Delicia Moore
Associate Chief Financial Officer
Human Support Services Cluster
FROM: Darrin Shaffer
Agency Fiscal Officer
Department of Health Care Finance
DATE: 06/01/2020
SUBJECT: Certification of Funding for the Managed Care Organization Contracts
AmeriHealth Caritas District of Columbia, Inc. CW83144
Trusted Health Plan (District of Columbia), Inc. DBA CareFirst BlueCross BlueShield Community
Health Plan CW83146
MedStar Family Choice CW83148
DHCF estimates that the cost of providing managed care coverage to Medicaid, Childrens Health Insurance Program
(CHIP), Immigrant Childrens Program, and Alliance beneficiaries from October 1, 2020 through September 30,
2021 through the contracts listed below will not exceed $1,492,392,346.13.
Contracts:
AmeriHealth Caritas District of Columbia, Inc. Contract Number: CW83144
Trusted Health Plan (District of Columbia), Inc.
DBA CareFirst BlueCross BlueShield Community Health Plan Contract Number: CW83146
MedStar Family Choice Contract Number: CW83148
This memorandum certifies that the Department of Health Care Finance has $1,492,392,346.13 in the FY 2021
proposed budget to support this cost from October 1, 2020 through September 30, 2021. This funding is sufficient to
support all of the beneficiaries expected to enroll in an MCO during the contract period.
Upon approval by Congress of the Districts Local Budget and Financial Plan, funds will be sufficient to pay the
cost associated with these contracts. There is no fiscal impact associated with these contracts.
Should you have any questions, please contact me at (202) 442-9079.
cc: Wayne Turnage, DHCF
Angelique Martin, DHCF
Melanie Bell, DHCF
Lisa Truitt, DHCF
441 4th Street, NW, Suite 900 South, Washington, D.C. 20001 (202) 442-5988 FAX (202) 478-1373
 GOVERNMENT OF THE DISTRICT OF COLUMBIA
Office of the Attorney General
xk *
ATTORNEY GENERAL, aa
KARL A. RACINE
Government Contracts Section
MEMORANDUM
TO: Ronan Gulstone
Director
Office of Policy and Legislative Affairs
FROM: Robert Schildkraut
Chief, Procurement Section
Commercial Division
DATE: July 8, 2020
SUBJECT: Managed Care Organizations
Contract No. CW83146
Contractor: Trusted Health Plan (District of
BlueCross BlueShield Community Health PlanColumbia, Inc.) dba CareFirst
Contract Term: October 1, 2020 September 31, 2021
Contract Amount: Not-to-Exceed $1,492,392,346.13 (for Contracts
CW83144, CW83146, and CW83148)
(PL567133)
This is to Certify that this Office has reviewed the above-referenced
Contract and we have found it to be legally sufficient contingent upon corrections
insurance certifications. to the
Ifyou have any questions in this regard, please do not hesitate to call me at (202)
724-4018,
Robert Schildkraut
441 Fourth Street, N.W., Suite 1010S, Washington, D.C.20001 (202) 727-3400
Fax (202) 347-8922
 1. Reserved for later use Page of Pages
AWARD/CONTRACT 1 282
2. Contract Number 3. Effective Date 4. Requisition/Purchase Request/Project No.
CW83146 See Box 20C
5. Issued By: Code 6. Administered by (If other than line 5)
Office of Contracting and Procurement Department of Health Care Finance
441 4th Street, N.W., 330 South