Exhibit 10.22.6           **AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT** **1. Contract Number** **Page of Pages** POHC-2002-D-0003  1   2        **2. Amendment/Modification Number** **3. Effective Date** **4.** **Requisition/Purchase Request No.** **5.** **Solicitation Caption**   M00015 1-Aug-04           **6. Issued By:** Code PO **7. Administered By (If other than line 6)**   Office of Conracting and Procurement         Department of Health / Office of Managed Care   Human Care and Services Group / DOH         Medical Assistance Administration   441 4th Street, N. W., Suite 700 South         825 North Capital Street, N. E., 5th Floor   Washington, DC 20001         Washington, D. C. 20001         Attn: Ms. Maude R. Holt — Telephone: (202) 442-9074     **8. Name and Address of Contractor (No. Street, city, country, state and ZIP Code)**   **9A. Amendment of Solicitation No.**   AMERIGROUP MARYLAND, INC.       A Managed Card Organization   **9B. Dated (See Item 11)**     d.b.a. AMERIGROUP DISTRICT OF COLUMBIA         750 1st Street, N. E., Suite 1120   **10A. Modification of Contract Order No.**   Washington, D. C. 20004         POHC-2002-D-0003   Attn: Ms. Jane E. Thom son — Telephone No.: (202) 218-4901 X **10B. Dated (See Item 13)****Code**’ 51-0387398                                                     Facility’         ’AUGUST 1, 2002 **11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS**Theabove numbered solicitation is amended as set forth in Item 14.The hour and date specified for receipt of Offerso is extended.o is not extended. Offers mustacknowledge receipt of this amendment prior to the hour and date specifiedin the solicitation or as amended, by one of thefollowing methods: (a) By completing Items 8 and 15, andreturning               copiesof the amendment: (b) By acknowledging receipt of thisamendment on each copy of the offer submitted; or(c) By separate letter or fax which includes a reference to the solicitation andamendment number. FAILURE OF YOUR ACKNOWLEDGEMENT TO BE RECEIVED AT THE PLACE DESIGNATEDFOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT INREJECTION OF YOUR OFFER. If by virtue of this amendment you desire to changean offer already submitted, such change may be made by letter or fax, providedeach letter or telegram makes reference to thesolicitation and this amendment, and is received prior to the opening hour and date specified.     **12. Accounting and Appropriation Data (If Required)**        **OCFO CERTIFICATION LETTER DATED JUINE 03, 2004** **$****87,124,011.28** **13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,**IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14     (x) A. This change order isissued pursuant to: (Specify Authority) **Section F.1.1.2“Option to Extend the Term of the Contract”**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, appropriationdate, 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 o is not, o is required to sign this document and return       copies to the issuing office.**14. Description of amendment/modification (Organized by UCF Section headings, including solicitation/contract subject matter where feasible.)** THE CONTRACT REFERENCED IN BLOCK 10A ABOVE IS MODIFIED AS FOLLOWS:     1.THE DISTRICT HEREBY EXERCISES ITS OPTION TO RENEW THIS CONTRACT INACCORDANCE TO SECTION F.1.2, TERM OF CONTRACT FOR THE PERIOD OF AUGUST 1, 2004THROUGH JULY 31, 2005. THE TOTAL PRICE FOR THIS OPTION IS $87,124,011.28.       2.A LIST OF RATES INCREASE FOR TREND EFFECTIVE FROM CONTRACT PERIODAUGUST 1, 2004 THROUGH JULY 31, 2005.       3.INCORPORATE THE DEPARTMENT OF LABOR WAGE DETERMINATION NO. 1994-2103,REVISION NO., 32, DATED 05/27/2004         Except as provided herein, all terms and conditions of the document referenced in Item 10A remain unchanged and in full force and effect.**15A. Name and Title of Signer (Type or print)**   16A. Name of Contracting Officer    Jane E. Thompson CEO        **ESTHER M. SCARBOROUGH**  15B. Name of Contractor **18. Date Signed** **16B. District of Columbia** **16C. Date Signed**AMERIGROUP District of Columbia      /s/ Jane E. Thompson **(Signature of person on authorized to s n)**  7/7/04       **(Signature of Contracting Officer)**