Proposed Contract to Contract No. CW113439 with Comagine Health

MURIEL BOWSER
MAYOR
May 29, 2026
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. M010 to Contract No. CW113439 with Comagine Health, which will
increase the not- to-exceed amount of option year two by $5,493,459, from $6,512,461.57 to
$12,005,920.57.
Under the proposed modification, Comagine Health will continue conducting utilization reviews
and quality improvement activities for participants in the District’s Fee-For-Service Medicaid
program. As a certified Quality Improvement Organization by the Centers for Medicare and
Medicaid Services, Comagine Health will perform these activities for both the Department of
Health Care Finance and the Department of Behavioral Health.
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
1

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
(Standard)

(A) Contract Number: CW113439

Proposed Contractor: Comagine Health

Proposed Contractor’s Principals: Foster C. Beall Jr.
Vice President

Total Contract Amount: $12,005,920.57 (including proposed increase of $5,493,459
via Modification No. M010)

Unit and Method of Compensation: Fixed Unit Price

Term of Contract: January 1, 2026, through December 31, 2026
(Option Year Two)

Type of Contract: Requirements Contract

Source Selection Method: Competitive Sealed Proposals

(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: $5,276,971.01
(Council Approval CA25-0656)

Option Period One Amount: $6,322,417.50
(Council Approval CA25-1107)

Explanation of difference from base period (if applicable):
The amount for option period one exceeds the price for the base period due to inflationary factors
related to the cost of operating a business and because of consumer price index (CPI) inflation that
2

measures the average change over time in the prices paid by urban consumers for a market basket
of consumer goods and services.

Option Period Two Amount: $6,512,461.57
(Council Approval CA26-0538)

Proposed increase of $5,493,459, from $6,512,461.57 to
$12,005,920.57 via Modification No. M010.

Explanation of difference from base period (if applicable):
The Department of Behavioral Health (“DBH”) and the Department of Health Care Finance
(“DHCF”) entered into a Memorandum of Understanding to transition DBH’s prior authorization
review process to Comagine, DHCF’s contracted Quality Improvement Organization. This will
improve safeguards against unnecessary or inappropriate use of Medicaid services; ensure the
provision of appropriate care through prospective, concurrent, and retrospective reviews of
services; review medical records; validate the appropriateness of requested services; improve data
gathering and reporting; and identify fraud, waste, abuse, and other violations. With the addition of
DBH services, the number of reviews will increase significantly, resulting in a higher overall price.
Furthermore, annual cost increases are driven by business operating expenses and inflationary
adjustments reflected in the CPI.

Option Period Three Amount: $11,231,376.28

Explanation of difference from base period (if applicable):
The amount for option period three exceeds the base year due to the transition of DBH’s prior
authorization review process to DHCF. Additionally, annual cost increases are driven by business
operating expenses and inflationary adjustments reflected in the CPI.

Option Period Four Amount: $11,900,098.86

Explanation of difference from base period (if applicable):
The amount for option period four exceeds the base year due to the transition of DBH’s prior
authorization review process to DHCF. Additionally, annual cost increases are driven by business
operating expenses and inflationary adjustments reflected in the CPI.

(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:

The contractor shall serve as a Quality Improvement Organization certified by the Centers for
Medicare & Medicaid Services in accordance with 42 C.F.R. § 431.630, to perform utilization
reviews and quality improvement activities for participants in the District’s Fee-for-Service
(“FFS”) Medicaid Program.

(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:

3

Solicitation Number Doc657330 was issued to the public on April 26, 2023, seeking competitive
sealed proposals. The solicitation closed on June 1, 2023. By the closing date, the District received
two timely proposals in response. The Contracting Officer (CO) evaluated the proposals based on
the criteria of Technical Approach and Methodology, Technical Expertise and Capacity, Technical
Experience and Past Performance, and Price. Following the evaluation, the CO determined that
Comagine Health submitted the most advantageous offer to the District and met all contractor
responsibility requirements.

(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:

None

(F) A description of any other contracts the proposed contractor is currently seeking or holds
with the District:

None

(G) 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 since 2018 and 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 contract. Likewise, it has been determined that the contractor maintains the
financial resources, accounting and operational controls to successfully fulfill the District’s
requirement. The contractor has been determined responsible in accordance with the District’s
standards of responsibility.

(H) 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 provided a subcontracting plan with a set-aside amount of $4,202,072.20, which is
35% of the total dollar amount. The CO has determined that the plan meets the Department of
Small and Local Business Development requirement.

(I) Performance standards and the expected outcome of the proposed contract:

4

The performance standards and expected outcome shall follow federal regulatory standards,
including, but not limited to, section 42 C.F.R. § 431.630 and sections §§ 1152 -1154 of the Social
Security Act. The contractor shall serve the District by conducting utilization reviews and quality
improvement services for its participants in the FFS Medicaid Program. By ensuring Medicaid
recipients receive appropriate and effective care while identifying opportunities for cost savings
and quality improvement, the contractor will play an essential role in helping the Department of
Health Care Finance (DHCF) and DBH achieve its mission of providing accessible, affordable,
high-quality healthcare for District residents. The contractor shall perform in accordance with
section C.5 of the contract and abide by District and Federal laws and regulations.

(J) 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

(K) 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 Office of the Chief Financial Officer has certified that funding is consistent with the
applicable financial plan and budget.

(L) 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 claims against the District.

(M) A certification that the 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):

The Citywide Clean Hands database indicates that the contractor is current with its District taxes.

(N) 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.

(O) A certification that the proposed contractor has been determined not to violate section 334a of
the Board of Ethics and Government Accountability Establishment and Comprehensive
Ethics Reform Amendment Act of 2011, D.C. Official Code § 1-1163.34a; and (2) A
5

certification from the proposed contractor that it currently is not and will not be in violation
of section 334a of the Board of Ethics and Government Accountability Establishment and
Comprehensive Ethics Reform Amendment Act of 2011, D.C. Official Code § 1-1163.34a:

The contractor has certified, via the Bidder/Offeror Certification form, that it is (1) not in violation
of section 334a of the Board of Ethics and Government Accountability Establishment and
Comprehensive Ethics Reform Amendment Act of 2011, D.C. Official Code § 1-1163.34a; and (2)
currently is not and will not be in violation of section 334a of the Board of Ethics and Government
Accountability Establishment and Comprehensive Ethics Reform Amendment Act of 2011, D.C.
Official Code § 1-1163.34a

(P) 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 not a District-certified business enterprise.

(Q) Other aspects of the proposed contract that the Chief Procurement Officer considers
significant:

None

(R) 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 22, 2026, the contractor does not appear on the Office of Inspector General Exclusions
Database, the Federal Excluded Parties List or the District’s list of Debarred and Suspended
Contractors.

(S) Any determination and findings issues relating to the contract’s formation, including any
determination and findings made under D.C. Official Code § 2-352.05 (privatization
contracts):

Determination and Findings for Contractor’s Responsibility
Determination and Findings for Price Reasonableness

(T) Where the contract, and any amendments or modifications, if executed, will be made
available online:

http://ocp.dc.gov

(U) Where the original solicitation, and any amendments or modifications, will be made available
online:

http://ocp.dc.gov
1101 4th Street, SW
Washington, DC 20024
Date of Notice: May 27, 2026 L0016614819Notice Number:
FEIN: **-***2875
Case ID: 18982148

Government of the District of Columbia
Office of the Chief Financial Officer
Office of Tax and Revenue
COMAGINE HEALTH
10700 MERIDIAN AVE N STE 300
SEATTLE WA 98133-9040

Branch Chief, Collection and Enforcement Administration
Authorized By Melinda Jenkins
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.
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
1101 4th Street SW, Suite W270, Washington, DC 20024/Phone: (202) 724-5045/MyTax.DC.gov

COPY
441 4th St. NW, Suite 900 South, Washington, D.C. 20001 (202) 442-5988 FAX (202) 478-1373
GOVERNMENT OF THE DISTRICT OF COLUMBIADepartment of Health Care Finance Office of the Chief Financial Officer MEMORANDUM TO: Nancy Hapeman 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: May 27, 2026 SUBJECT: Certification of Funding for the Comagine Health Contract The Office of the Chief Financial Officer hereby certifies that the sum of $12,005,920.57 Local Budget and Financial Plan for Fiscal Year 2026 to fund the costs associated with the Department of Health (DHCF) contract solicitation for the Comagine Health contract. This certification supports the Comagine Health contract during the period from January 01, 2026 through December 31, 2026. This certification replaces funding certifications dated 10/21/2025 and 02/17/2026. The fund allocation is as follows: Vendor: Comagine Health Contract #: CW113439 Fiscal Year 2026 Funding: 1/1/2026 9/30/2026 Agency DIFS Fund DIFS Cost Center DIFS Program DIFS Account Awards Project Amount RM0 1010001 70424 700286 7132001 1001077 403540 $946,800.00 HT0 4025002 70528 100180 7132001 2002472 200881 $2,840,400.00 RM0 1010001 70427 700285 7132001 1001077 403540 $603,970.01 HT0 4025002 70528 100180 7132001 2002472 200881 $1,811,910.04 HT0 1010001 70528 100180 7132001 Blank Blank $851,332.60 HT0 4025002 70528 100180 7132001 2002472 200881 $2,553,997.79 FY 2026 Contract Total $9,608,410.44 Fiscal Year 2027 Funding: 10/1/2026 12/31/2026 Agency DIFS Fund DIFS Cost Center DIFS Program DIFS Account Awards Project Amount HT0 1010001 70528 100180 7132001 Blank Blank $599,377.53 HT0 4025002 70528 100180 7132001 2002472 200881 $1,798,132.60 FY 2027 Contract Total $2,397,510.13 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 further questions, please contact me at 202-442-9079.

GOVERNMENT OF THE DISTRICT OF COLUMBIA
Office of the Attorney General

ATTORNEY GENERAL
BRIAN L. SCHWALB

Commercial Division

MEMORANDUM

TO: Tomás Talamante
Director
Office of Policy and Legislative Affairs

FROM: Robert Schildkraut
Section Chief
Government Contracts Section

DATE: May 19, 2026

SUBJECT: Approval of Modification to Option Years Two, Three, and Four for
Utilization Management and Quality Improvement
Contract Number: CW113439
Contractor: Comagine Health
Proposed Contract Amount: OY2: $12,005,920.57; OY3: $11,076,196.60;
OY4: $11,740,283.98

This is to Certify that this Office has reviewed the above-referenced Contract and have found it to
be legally sufficient.

If you have any questions in this regard, please do not hesitate to call me at (202) 724-4018.

______________________________
Robert Schildkraut

AMENDMENT OF SOLICITATION / MODIFICATION OF CONTRACT
1. Contract Number Page of Pages
CW113439 1 3
2. Amendment/Modification Number 3. Effective Date 4. Requisition/Purchase Request
No.
5. Solicitation Caption
M010 See 16C. Utilization Management and
Quality Improvement
6. Issued by: Code 7. Administered by (If other than line 6)
Office of Contracting and Procurement
Health Services Cluster
441 4th Street NW, Suite 300S
Washington, DC 20001
Department of Health Care Finance
Division of Clinician, Pharmacy & Acute Provider Services
441 4th Street, NW, Suite 900S
Washington, DC 20001
8. Name and Address of Contractor (No. street, city, county, state, and zip code)
Comagine Health
10700 Meridian Ave. N., Suite 300
Seattle, WA 98133
POC: Foster C. “Bud” Beall Jr., Vice President, Care Management
Office: 800-949-7536 x2041
Email: bbeall@comagine.org
9A. Amendment of Solicitation No.
9B. Dated (See Item 11)
X
10A. Modification of Contractor/Order No.
CW113439
10B. Dated (See Item 13)
January 1, 2024
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)
X C. This supplemental agreement is entered into pursuant to authority of: 27 DCMR § 3601. 2
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 CW113439 is hereby modified as follows:
D
ue to the Department of Behavior Health's (DBH) prior authorization review process several Contract Line
Item Numbers (CLINs) have been modified to accommodate the increased demand. The specific changes for
each option year are as follows:
1. Option Year Two Contract Changes - 2001 Prior Authorization Reviews
1.1 New CLIN 2001E-a: Added to specifically track DBH Prior Authorization Review usage an additional
estimated quantity of 60,000 usage and the total estimated amount of $3,787,200 added.
1.2 CLIN 2001F DME/POS: Estimated quantity increased by 3,000 from 2,000 to 5,000. The total
estimated amount increased by $189,360 from $126,240.00 to $315,600.
o Total for 2001 Prior Authorization Reviews: The overall total increased by $3,976,560, from
$980,745.52 to $4,957,305.52.
1.3 CLIN 2005A Utilization Review Related Activities: Total Estimated Amount increased by $1,516,984
from $898,896.05 to $2,415,880.05.
o Total for 2005 Utilization Review Related Activities: The overall total increased by $1,516,984
from $898,896.05 to $2,415,880.05.
2
2. Option Year Three Contract Changes - 3001 Prior Authorization Reviews
2.1 Ne w CLIN 3001E- a: Added to specifically track DBH Prior Authorization Review usage an additional
estimated quantity of 65,000 usage and the total estimated amount of $4,226,300 added.
2.2 CLIN 3001F DME/POS: Estimated quantity increased by 3,000 from 2,000 to 5,000. The total
estimated amount increased by $195,060 from $130,040 to $325,100.
2.3 CLIN 3001G Eye Ware and Contact Lenses: Estimated quantity increased by 1,400 from 1,600 to
3,000. The total estimated amount increased by $58,898 from $67,312 to 126,210
2.4 CLIN 3001J SUD Residential Treatment Concurrent Review: Estimated quantity increased by 176
from 524 to 700. The total estimated amount increased by $48,079.70 from $143,146.30 to $191,226
o Total for 3001 Prior Authorization Reviews: The overall total increased by $4,528,337.68, from
$1,010,204.32 to $5,538,542.
2.5
3003 Service Reviews as Described in C.5.3
2.6
CLIN 3003C Katie Beckett/TEFRA: Estimated quantity decreased by 176 from 476 to 300. The total
estimated amount decreased by $48,079.68 from $130,033.68 to $81,954
o Total for 3003 Service Reviews as Described in C.5.3: The overall total decreased by
$48,079.68 from $1,093,624.43 to $1,045,544.75.
2.7
3004 Data Entry Only as described in C.5.4
2.8
CLIN 3004B EPD/SMW : Estimated quantity decreased by 2,800 from 4,000 to 1,200. The total
estimated amount decreased by $107,100 from $153,000 to $45,900.
o Total for 3004 Data Entry Only as described in C.5.4: The overall total decreased by $107,100
from $688,480 to $581,380.
2.
9 Option Period Three is projected to increase by $4,373,158 from $6,703,038.60 to $11,076,196.60
3. Option Year Four Contract Changes - 4001 Prior Authorization Reviews
3.1 New CLIN 4001E-a: Added to specifically track DBH Prior Authorization Review usage an additional
estimated quantity of 70,000 usage and the total estimated amount of $4,687,900 added.
3.2 CLIN 4001F DME/POS: Estimated quantity increased by 3,000 from 2,000 to 5,000. The total
estimated amount increased by $200,910 from $133,940 to $334,850.
3.3 CLIN 4001G Eye Ware and Contact Lenses: Estimated quantity increased by 1,400 from 1,600 to
3,000. The total estimated amount increased by $60,662 from $69,328 to $129,990
3.4 CLIN 4001J SUD Residential Treatment Concurrent Review: Estimated quantity increased by 176
from 524 to 700. The total estimated amount increased by $49,522.88 from $147,443.12 to $196,966
o Total for 4001 Prior Authorization Reviews: The overall total increased by $4,998,994.88, from
$1,040,529.62 to $6,039,524.50.
3
3.5 4003 Service Reviews as Described in C.5.3
3.6
CLIN 4003C Katie Beckett/TEFRA: Estimated quantity decreased by 176 from 476 to 300. The total
estimated amount decreased by $49,522.88 from $133,936.88 to $89,414.
o Total for 4003 Service Reviews as Described in C.5.3: The overall total decreased by
$49,522.88 from $1,127,471.63 to $1,077,948.75.
3.7
4004 Data Entry Only as described in C.5.4
3.8
CLIN 4004B EPD/SMW: Estimated quantity decreased by 2,800 from 4,000 to 1,200. The total
estimated amount decreased by $110,292 from $157,560 to $47,268
o Total for 4004 Data Entry Only as described in C.5.4: The overall total decreased by $110,292
from $709,040 to $598,748.
3.9
Option Period Four is projected to increase by $4,839,180 from $6,901.103.98 to $11,740,283.98
4. B
y this modification the total contract value for Option Period Two increased by $5,493,459, from
$6,512,461.57 to $12,005,920.57.
5. A
ttachment - Revised Price Schedules B.3.3 through B.3.5 is hereby incorporated and made a part of this
contract.
A
LL 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
Tracy Williams
15B. Comagine Health
(Signature of person authorized to sign)
15C. Date Signed 16B. District of Columbia
(
Signature of Contracting Officer)
16C. Date Signed
5/18//2026
Foster C. "Bud" Beall, Jr. - Vice President, Care Management