MURIEL BOWSER
MAYOR
December 20, 2022
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 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. M0005 to Contract No. CW95350 with UnitedHealthcare of the Mid-
Atlantic to exercise option year one in the not-to-exceed amount of $228,886,857.96. The period of
performance is from January 1, 2023, through December 31, 2023.
1. Under the proposed modification, United Healthcare of the Mid-Atlantic shall continue to
provide medically necessary services for physical, behavioral, and long-term health services
for the Medicaid-eligible population enrolled in the Districts Dual Eligible Special Needs
Program (D-SNP). The D-SNP program consists of Full-Benefit Dual Eligible beneficiaries
who meet both Medicare and Medicaid requirements and are enrolled in both programs.
I am available to discuss any questions you may 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, Office of Contracting and Procurement, at (202) 724-8759.
I look forward to the Councils favorable consideration of this contract.
Sincerely,
Muriel Bowser
Enclosure
 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: CW95350
Proposed Contractor: UnitedHealthcare of the Mid-Atlantic
Contract Amount (Option Period One): Minimum $92,754,537.12, Maximum: $228,886,857.96
Unit and Method of Compensation: Fixed Capitated Rates
Term of Contract: January 1, 2023, through December 31, 2023
Type of Contract: Indefinite Delivery Indefinite Quantity
(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: NTE $192,786,889.35
(February 1, 2022 December 31, 2022)
(Council Approval CA24-0373)
Option Period One Amount: NTE $228,886,857.96
(January 1, 2023 December 31, 2023)
(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 11, 2022, the Citywide Clean Hands database certified that UnitedHealthcare of the
Mid-Atlantic is current with its District tax laws.
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(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 $194,349,804.99 is available to support the contract.
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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: October 11, 2022 Notice Number: L0008292338
UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC. FEIN: **-***0183
10175 LITTLE PATUXENT PKWY Case ID: 1315479
COLUMBIA MD 21044-2655
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 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: George A. Schutter
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: October 21, 2022
SUBJECT: Certification of Funding for the Dual Eligible Special Needs Program Contract
The Office of the Chief Financial Officer hereby certifies that the sum of $194,349,804.99 is included in the
2023 to fund the costs associated with the Department of
Dual Eligible Special Needs Program contract. This certification supports the Dual
Eligible Special Needs Program contract cost from January 1, 2023 to December 31, 2023. The fund allocation is as
follows:
Vendor: United Healthcare of Mid-Atlantic, Inc. Contract #: CW95350
Fiscal Year 2023 Funding: 01/01/23-09/30/23
DIFS
DIFS DIFS DIFS
Agency Fund Index PCA Object Cost Amount
Fund Program Account
Center
DSNP -EPD
HT0 0100 LF194 F1940 0409 1010001 70487 700340 7132001 $ 25,455,075.10
HT0 8250 F1943 F1940 0409 4025002 70487 700340 7132001 $ 65,672,878.71
DSNP-Non EPD
HT0 0100 LF195 F1950 0409 1010001 70487 700105 7132001 $15,185,116.53
HT0 8250 F1953 F1950 0409 4025002 70487 700105 7132001 $39,176,875.81
FY 2023 Contract Total: $145,489,946.15
441 4th St. NW, Suite 900 South, Washington, D.C. 20001 (202) 442-5988 FAX (202) 478-1373
Fiscal Year 2024 Funding: 10/01/23-12/31/23
DIFS
DIFS DIFS DIFS
Agency Fund Index PCA Object Cost Amount
Fund Program Account
Center
DSNP -EPD
HT0 0100 LF194 F1940 0409 1010001 70487 700340 7132001 $9,112,795.38
HT0 8250 F1944 F1940 0409 4025002 70487 700340 7132001 $21,263,189.22
DSNP-Non EPD
HT0 0100 LF195 F1950 0409 1010001 70487 700105 7132001 $5,545,162.27
HT0 8250 F1954 F1950 0409 4025002 70487 700105 7132001 $12,938,711.97
FY 2024 Contract Total: $48,859,858.84
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
CW95350 1 2
2. Amendment/Modification Number 3. Effective Date 4. Requisition/Purchase 5. Solicitation Caption
Request No.
M0005 January 1, 2023 Dual Eligible Special Needs Program
(D-SNP)
6. Issued by: Code 7. Administered by (If other than line 6)
Office of Contracting and Procurement Department of Health Care Finance
Health and Human Services Cluster Long Term Care Administration
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 code) 9A. Amendment of Solicitation No.
UnitedHealthcare of the Mid-Atlantic, Inc.
10175 Little Patuxent Parkway, 6th Floor 9B. Dated (See Item 11)
Columbia, MD 20144 10A. Modification of Contractor/Order No.
POC: Erin Henderson Moore CW95350
Email: erin_hendersonmoore@uhc.com X 10B. Dated (See Item 13)
February 1, 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 one (1) copy 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 CONTRACTORS/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 3601.3 (a)
C. This supplemental agreement is entered into pursuant to authority of: 27 DCMR 3601.2
X D. Other: Exercise of Option, pursuant to the authority of: 27 DCMR 3601.3 (c)
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. CW95350 is hereby modified as follows:
1) In accordance with Section F.2 titled Option to Extend the Term of the Contract, the District of
Columbia Government, Office of Contracting and Procurement, on behalf of the Department of Health
Care Finance, hereby exercises option period one to extend the term of the contract from January 1, 2023,
through December 31, 2023. The maximum contract amount for 12 months is $228,886,857.96.
2) Attachment A: Price Schedule for Option Period One is incorporated and made a part of the contract.
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
Kathlyn Wee
CEO, UnitedHealthcare Community Plan of DC Jarad Dorsey
15B. Name of Contractor 15C. Date 16B. District of Columbia 16C. Date Signed
Signed
Type text here 9/30/2022
(Signature of person authorized to sign) (Signature of Contracting Officer)
ATTACHMENT A M0005 CW95350 D-SNP UNITEDHEALTHCARE
B.3 PRICE SCHEDULE
B.3.1 The Contractor shall propose capitation rates based on the lower bound rates from an actuarially sound
range as outlined in Attachment J.13 (Mercers Actuarial Rate Setting Memo) prepared on August 31,
2022, and in accordance with 42 CFR 438.4 and 42 CFR 438.6. The Contractor shall analyze its own
projected medical expense, administrative expense, and any other premium needs for comparison to the
lower bound rates. DHCF may reimburse the Contractor at a proposed rate up to, but not exceeding, the
target rate within the actuarially sound upper and lower bound capitation rates as established by DHCFs
Actuary. Enrollee estimates are not guaranteed due to the uncertainty surrounding the number of eligible
beneficiaries. The District has included enrollment estimates for each rate cohort in Section B.3 to allow
the Contractor to develop pricing for option period one utilizing the fixed capitated rates in Attachment
J.13. This is not intended to be a requirements contract. This is an IDIQ contract pursuant to the
minimum and maximum requirements in section B.2.1.
B.3.3 OPTION PERIOD ONE
January 1, 2023, through December 31, 2023
Minimum Maximum
Actuarially
CLIN Rate Cohort* Monthly Monthly
Sound Rates Enrollment Enrollment
1001 D-SNP
Elderly and Persons with
1001AA Disabilities (EPD) Waiver $7,095.09 660 1,781
Enrollees
1001AB Long-Term Nursing Facility $10,151.62 108 190
(NF) Residents
1001AC Community Well $639.79 2,760 6,381
1001AD Cost-Sharing Only Duals $73.25 2,520 5,819
Monthly Totals $7,729,544.76 $19,073,904.83
Grand Totals for Option Period One $92,754,537.12 $228,886,857.96
*Individuals are categorized into applicable rate cells by Medicaid programmatic eligibility information
contained within the Districts MMIS and reflected in each Enrollees Medicaid program eligibility
code.
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