MURIEL BOWSER
MAYOR
May 24, 2024
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 section 202 of the Procurement Practices Reform Act of 2010 (D.C. Official Code §
2-352.02 et seq.), enclosed for consideration and approval by the Council of the District of
Columbia is proposed modification No. M0005 to exercise option period two of Contract No.
CW97894 with Magellan Medicaid Administration, Inc, (Magellan). The proposed modification
is in the amount of $5,954,615.04. The proposed modification is for the period of July 20, 2024
through July 19, 2025.
Under the proposed modification, Magellan shall continue to operate, monitor, and administer the
Pharmacy Benefit Manager System and Pharmacy Support Services for eligible District
beneficiaries.
I am available to discuss any questions you may have regarding the proposed modification. 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 proposed modification.
Sincerely,
Muriel Bowser
 GOVERNMENT OF THE DISTRICT OF COLUMBIA
Office of Contracting and Procurement
Pursuant to section 202(c-3) of the Procurement Practices Reform Act of 2010, as amended, D.C.
Official Code § 2-352.02(c-3), the following contract summary is provided:
COUNCIL CONTRACT SUMMARY
(Options)
(A) Contract Number: CW97894
Proposed Contractor: Magellan Medicaid Administration, Inc. (Magellan)
Contract Amount (Option Period Two): $5,954,615.04
Term of Contract: July 20, 2024 through July 19, 2025
Type of Contract: Firm Fixed Price
(B) Identifying number of the underlying contract, including the identifiers assigned to the
underlying contract by the Council for the base period and any subsequent option periods:
Base Year Amount: $5,532,229.92
(July 20, 2022 through July 19, 2023)
Council Approval CA24-0648
Option Period One Amount: $5,781,180.24
(July 20, 2023 through July 19, 2024)
Council Approval CA25-0239
Option Period Two Amount: $5,954,615.04
(July 20, 2024 through July 19, 2025)
Explanation of difference from base period (if applicable):
The amount for option period two exceeds the price for the base period due to the inflationary
factors related to the cost of operating a business using the Consumer Price Index inflation that
measures the average change over time in the prices paid by urban consumers for a market basket of
consumer goods and services.
1
 Option Period Three Amount: $6,133,354.12
(July 20, 2025 through July 19, 2026)
Explanation of difference from base period (if applicable):
The amount for option period three exceeds the price for the base period due to the inflationary
factors related to the cost of operating a business using the Consumer Price Index inflation that
measures the average change over time in the prices paid by urban consumers for a market basket of
consumer goods and services.
Option Period Four Amount: $6,317,251.80
(July 20, 2026 through July 19, 2027)
Explanation of difference from base period (if applicable):
The amount for option period four exceeds the price for the base period due to the inflationary
factors related to the cost of operating a business using the Consumer Price Index inflation that
measures the average change over time in the prices paid by urban consumers for a market basket of
consumer goods and services.
(C) A statement 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 April 23, 2024, the Citywide Clean Hands database certified that Magellan is current with its
District taxes.
(D) A statement 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 Department of Health Care Finance Agency Fiscal Officer certified that funding in the amount
of $1,184,520.20 is available to support the contract in FY 24 and that the remaining amount,
$4,770,094.84 will be available in FY 25 upon the approval of the FY 25 budget.
 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: April 23, 2024 Notice Number: L0011757214
MAGELLAN MEDICAID ADMINISTRATION INC FEIN: **-***9793
2900 AMES CROSSING RD Case ID: 4385703
EAGAN MN 55121-2498
CERTIFICATE OF CLEAN HANDS
As reported in the Clean Hands system, the above referenced individual/entity has no outstanding
CO
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)
PY
§ 47-2862 PROHIBITION AGAINST ISSUANCE OF LICENSE OR PERMIT
Authorized By Melinda Jenkins
Branch Chief, Collection and Enforcement Administration
To validate this certificate, please visit MyTax.DC.gov. On the MyTax DC homepage, click the
“Validate a Certificate of Clean Hands” hyperlink under the Clean Hands section.
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: Nancy Hapeman
Acting Chief Procurement Officer
Office of Contracting and Procurement
THRU: Delicia V. Moore
Associate Chief Financial Officer
Human Support Services Cluster
FROM: Darrin Shaffer
Agency Fiscal Officer
Department of Health Care Finance
DATE: May 16, 2024
SUBJECT: Pharmacy Benefit Manager System (PBMS) – Magellan Medicaid Administration Inc Contract
The Office of the Chief Financial Officer hereby certifies that the sum of $5,954,615.04 is included in the District’s
Local Budget and Financial Plan for Fiscal Year 2024 to fund the costs associated with the Department of Health
Care Finance’s (DHCF) Pharmacy Benefit Manager System (PBMS) contract. This certification supports the
Magellan Medicaid Administration, Inc contract cost from July 20, 2024 through July 19, 2025. The fund allocation
is as follows:
Vendor: Magellan Medicaid Administration, Inc Contract# CW97894
Fiscal Year 2024 Funding: - 07/20/2024-09/30/2024
Agency Fund Account Program Cost Center Amount
HT0 1010001 7132001 700087 70261 $46,622.62
HT0 4025002 7132001 700087 70261 $139,867.87
HTO 1010001 7132001 700087 70261 $548,916.34
HTO 4025002 7132001 700087 70261 $449,113.37
FY 2024 Contract Total: $1,184,520.20
Fiscal Year 2025 Funding: 10/01/2024-07/19/2025
Agency Fund Account Program Cost Center Amount
HT0 1010001 7132001 100203 70261 $2,623,552.16
HT0 4025002 7132001 100203 70261 $2,146,542.68
FY 2025 Contract Total: $4,770,094.84
Upon approval of the District’s Local Budget and Financial Plan by the Council and the Mayor and completion of
the thirty-day Congressional layover, funds will be sufficient to pay for fees and costs associated with the contract.
There is no fiscal impact associated with the contract.
Should you have any questions, please contact me at (202) 442-9079.
441 4th St. NW, Suite 900 South, Washington, D.C. 20001 (202) 442-5988 FAX (202) 478-1373
 1. Contract Number Page of Pages
AMENDMENT OF SOLICITATION / MODIFICATION OF CONTRACT CW97894 1 1
2. Amendment/Modification Number 3. Effective Date 4. Requisition/Purchase Request No. 5. Solicitation Caption
Pharmacy Benefit Manager
M0005 July 20, 2024 System O&M
6. Issued by: Code 7. Administered by (If other than line 6)
Office of Contracting and Procurement Department of HealthCare Finance
441 4th Street NW, Suite 330S 441 4th Street, NW Suite 900S
Washington, DC 20001 Washington, DC 20001
8. Name and Address of Contractor (No. street, city, county, state, and zip 9A. Amendment of Solicitation No.
code)
9B. Dated (See Item 11)
Magellan Medicaid Administration, Inc 10A. Modification of Contract/Order No.
11013 W. Broad Street, Suite 500
Glen Allen, VA 23060 X CW97894
10B. Dated (See Item 13)
Code Facility 9/26/2022
11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS
The above numbered solicitation is amended as set forth in item 14. The hour and date specified for receipt of Offers is extended. is not extended.
Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:
(a) By completing Items 8 and 15 and returning __________ copies of the amendment: (b) By acknowledging receipt of this amendment on each copy of the offer
submitted; or (c) BY separate letter or fax which includes a reference to the solicitation and amendment number. FAILURE OF YOUR ACKNOWLEDGMENT TO
BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION
OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such may be made by letter or fax, provided each letter or
telegram makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.
12. Accounting and Appropriation Data (If Required)
13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACT/ORDERS,
IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14
A. This change order is issued pursuant to (Specify Authority): 27 DCMR, Chapter 36, Contract Modifications
The changes set forth in Item 14 are made in the contract/order no. in item 10A.
B. The above numbered contract/order is modified to reflect the administrative changes (such as changes in paying office, appropriation data
etc.) set forth in item 14, pursuant to the authority of 27 DCMR, Chapter 36, Section 3601.2.
C. This supplemental agreement is entered into pursuant to authority of:
D. Other: Exercise of Option pursuant to authority of 27 DCMR § 2008
x
E. IMPORTANT: Contractor is not required is required to sign this document and return one (1) copy to the issuing office.
14. Description of Amendment/Modification (Organized by UCF Section headings, including solicitation/contract subject matter where feasible.)
Contract No: CW97894 is hereby modified to incorporate the following:
1. Pursuant to Section F.2 of the contract, Option to Extend the Term of the Contract, the District hereby
exercises Option Period Two for the period of performance from July 20, 2024 through July 19, 2025, in
the amount of $5,954,615.04.
2. Attachment A: Option Period Two Price Schedule
All other terms and conditions remains unchanged
Except as provided herein, all terms and conditions of the document is referenced in Item 9A or 10A remain unchanged and in full force and effect.
15A. Name and Title of Signer (Type or print) 16A. Name of Contracting Officer
Jarad Dorsey
15B. Name of Contractor 15C. Date Signed 16B. District of Columbia 16C. Date Signed
(Signature of person authorized to sign) (Signature of Contracting Officer)
 ATTACHMENT A: OPTION PERIOD TWO PRICE SCHEDULE
B.3.2 Option Period Two: July 20, 2024, through July 19, 2025
CLIN Item Description Unit Quantity Unit Price Total Amount
Administration and maintenance of the
District's PBMS with a POS component
2001 for eligible District beneficiaries, and to Month 12 $496,217.92 $5,954,615.04
provide described programs and services
in Section C.5.
OPTION YEAR OPERATIONS COST TOTAL: $5,954,615.04