MURIEL BOWSER
MAYOR
December 12, 2024
The Honorable Phil Mendelson
Chairman, Council of the District of Columbia
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), enclosed for consideration and approval by the Council of the District of Columbia
is proposed Modification No. 0009 to Contract No. CW88488 with Magellan Medicaid
Administration, Inc. (Magellan) to exercise option period four in the amount of $1,076,438. The
period of performance is from January 1, 2025, through December 31, 2025.
Under the proposed modification, Magellan shall continue to develop and administer the
District’s preferred drug list and supplemental rebate program for its 40,000 fee-for-service
beneficiaries.
My administration is available to discuss any questions you may have regarding the proposed
contract modification. In order to facilitate a response to any questions you may have, please
have your staff contact Marc Scott, Chief Operating Officer, Office of Contracting and
Procurement, at (202) 724-8759.
I look forward to the Council’s favorable consideration of this contract 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: CW88488
Proposed Contractor: Magellan Medicaid Administration Inc.
Contract Amount (Option Period Four): $1,076,438
Term of Contract: January 1, 2025, through December 31, 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 Period Amount: $956,401
(January 1, 2021, through December 31, 2021)
Option Period One Amount: $985,093
(January 1, 2022, through December 31, 2022)
Option Period Two Amount: $1,014,646
(January 1, 2023, through December 31, 2023)
(Council Approval CA24-0773)
Option Period Three Amount: $1,045,085
(January 1, 2024, through December 31, 2024)
(Council Approval CA25-0531)
Option Period Four Amount: $1,076,438
Explanation of difference from base period: Preferred drug list and supplemental rebate costs
experience a three percent increase in cost every year as the preferred drug list and supplemental
rebate operations increase as well as factors related to the cost of operating a business.
1
(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 October 24, 2024, the Citywide Clean Hands database certified that the Contractor 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 $1,076,438 is available to support the contract for the preferred drug list and supplemental rebate
contract.
2
 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: October 24, 2024 Notice Number: L0012810673
MAGELLAN MEDICAID ADMINISTRATION INC FEIN: **-***9793
2900 AMES CROSSING RD Case ID: 18291814
EAGAN MN 55121-2498
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 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: November 12, 2024
SUBJECT: Certification of Funding for the Magellan PDL Contract
The Office of the Chief Financial Officer hereby certifies that the sum of $1,076,438.00 is included in the District’s
Local Budget and Financial Plan for Fiscal Year 2025 to fund the costs associated with the Department of Health
Care Finance’s (DHCF) Magellan PDL contract. This certification supports the PDL Contract during the period
from January 1, 2025 through December 31, 2025. The fund allocation is as follows:
Vendor: Magellan DHCF Contract #: CW88488
Fiscal Year 2025 Funding: 01/01/2025-09/30/2025
Cost
Agency Fund Account Program Project Award Amount
Center
HT0 1010001 7132001 100187 70160 000000 0000000 $444,030.68
HT0 4025002 7132001 100187 70160 200881 2001984 $363,297.82
FY25 Contract Total $807,328.50
Fiscal Year 2026 Funding: 10/01/2025-12/31/2025
Cost
Agency Fund Account Program Project Award Amount
Center
HT0 1010001 7132001 100187 70160 000000 0000000 $148,010.22
HT0 4025002 7132001 100187 70160 200881 2001984 $121,099.28
FY26 Contract Total $269,109.50
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
CW88488 1 2
AMENDMENT OF SOLICITATION / MODIFICATION OF CONTRACT
2. Amendment/Modification Number 3. Effective Date 4. Requisition/Purchase Request No. 5. Solicitation Caption
Preferred Drug List &
CW88488-M0009 January 1, 2025 Supplemental Program (PDL)
6. Issued by: Code 7. Administered by (If other than line 6)
Office of Contracting and Procurement Department of Health Care Finance
441 4th Street NW, Suite 330S 441 4th Street Suite 900 South
Washington, DC 20001 Washington, DC 20001
8. Name and Address of Contractor (No. street, city, county, 9A. Amendment of Solicitation No.
state and zip 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 CW88488
10B. Dated (See Item 13)
Code Facility December 30, 2020
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
X 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 (Specify type of modification and authority)
E. IMPORTANT: Contractor is not is required to sign this document.
14. Description of Amendment/Modification (Organized by UCF Section headings, including solicitation/contract subject matter where feasible.)
Contract No. CW88488 is hereby modified as follows:
1. Pursuant to Section F.2.1, Option to extend the term of the contract, the Contracting Officer hereby exercises Option Period
Four, for the period of performance from January 1, 2025, through December 31, 2025, in the amount of $1,076,438.
2. Attachment A – Option Period Four Price Schedule
All other terms and conditions remain 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
B.3.5 Option Period Four
Contract Line
Item Description Total Price
Item No. (CLIN)
Develop and administer the District’s Preferred Drug
4001 List (PDL) and Supplemental Rebate (SR) Program as $1,076,438.00
described in Section C.5
Grand Total for B.3.5 $1,076,438.00
2