AMERIGROUP FLORIDA, INC. Medicaid HMO Contract AHCA CONTRACT NO. FA523 AMENDMENT NO. 10

EX-10.25.10 5 w20799exv10w25w10.htm EX-10.25.10 exv10w25w10

Exhibit 10.25.10

STATE OF ILLINOIS
DEPARTMENT OF PUBLIC AID


AMERIGROUP FLORIDA, INC.		Medicaid HMO Contract

AHCA CONTRACT NO. FA523
AMENDMENT NO. 10

THIS CONTRACT, entered into between the STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, hereinafter referred to as the “Agency” and AMERIGROUP FLORIDA, INC., hereinafter referred to as the “Vendor”, is hereby amended as follows:

Attachment I, section 90.0, Payment and Authorized Enrollment Levels, is hereby deleted in its entirety and replaced with the following:

90.0

PAYMENT AND AUTHORIZED ENROLLMENT LEVELS

	a.		The Agency assigns the Plan an authorized maximum enrollment level for each operational county, and the Agency shall pay the Plan capitation payments for each Agency operational area, in accordance with the following table. The Agency shall pay the Plan capitation payments based on the Agency operational area (or rate zone) age group, gender and authorized services, in accordance with Attachment VIII-A.

	b.		The authorized maximum enrollment level is in effect as of July 1, 2005, or upon Contract execution, whichever is later. The Agency must approve in writing any increase in the Plan’s maximum enrollment level for each operational county. Such approval shall not be unreasonably withheld, and shall be based on the Plan’s satisfactory performance of terms of the Contract and approval of the Plan’s administrative and service resources, as specified in this Contract, in support of each enrollment level.

	c.		Table 1 provides the Plan’s Contract enrollment levels.

	d.		Table 2 provides the authorized areas of operation and respective capitation rates, which are located in Attachment VIII-A.

Table 1
Enrollment Levels


County	Maximum Enrollment Level
BREVARD		8,000
BROWARD		14,000
DADE		25,000
HILLSBOROUGH		40,000
LEE		18,000
MANATEE		3,500
ORANGE		30,000
OSCEOLA		8,500
PALM BEACH		12,000
PASCO		15,000
PINELLAS		25,000
POLK		30,000
SARASOTA		8,000
SEMINOLE		8,000

AHCA Contract No. FA523, Amendment No. 10, Page 1 of 3


AMERIGROUP FLORIDA, INC.		Medicaid HMO Contract

Table 2
Capitation Rates

(i)

General Capitation Rates plus Mental Health Rates (Attachment VIII-A, Table 4):

Area 5 Counties:


County	Provider Number
Pasco		015005304
Pinellas		015005305

Area 6 Counties:


County	Provider Number
Hillsborough		015005300
Polk		015005307
Manatee		015005318

Area 7 Counties:


County	Provider Number
Orange		015005308
Seminole		015005313
Osceola		015005314
Brevard		015005336

Area 8 Counties:


County	Provider Number
Lee		015005302
Sarasota		015005306

Area 9 Counties:


County	Provider Number
Palm Beach		015005310

Area 10 Counties:


County	Provider Number
Broward		015005311

Area 11 Counties:


County	Provider Number
Dade		015005312

For Plans participating in the frail/elderly program, the community rate shall be paid for all members in each eligibility category except for those SSI members determined by the Comprehensive Assessment and Review for Long Term Care (CARES) Unit to be at risk of nursing home institutionalization. Evidence of such assessments shall be provided to the

AHCA Contract No. FA523, Amendment No. 10, Page 2 of 3


AMERIGROUP FLORIDA, INC.		Medicaid HMO Contract

			Agency by the Plan prior to authorization by the Agency of payment of the institutional rates. Payment of institutional rates for any eligible enrollee shall continue only so long as the enrollee meets the level of care requirements for institutionalization, otherwise, the community capitation rate applies.

	f.		Notwithstanding the payment amounts which may be computed with the rate table outlined in Attachment VIII-A, the sum of total capitation payments under this Contract shall not exceed the total Contract amount of $680,379,083.00 expressed on page seven (7) of this Contract.

2.		Attachment VIII, Estimated 2005-2006 Rates; Not for use unless approved by CMS, is hereby deleted in its entirety and replaced with Attachment VIII-A, 2005/2006 Medicaid HMO Capitation Rates.

3.		This Amendment shall have an effective date of March 1, 2006, or the date on which both parties execute the Amendment, whichever is later.

All provisions in the Contract and any attachments thereto in conflict with this Amendment shall be and are hereby changed to conform with this Amendment.

All provisions not in conflict with this Amendment are still in effect and are to be performed at the level specified in the Contract.

This Amendment, and all its attachments, are hereby made part of the Contract.

This Amendment can not be executed unless all previous Amendments to this Contract have been fully executed.

IN WITNESS WHEREOF, the parties hereto have caused this 6 page amendment (including all attachments) to be executed by their officials thereunto duly authorized.


AMERIGROUP FLORIDA, INC.		STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION

SIGNED		SIGNED
BY: /s/ Don Gilmore		BY: /s/ Alan Levine


NAME: Don Gilmore		NAME: Alan Levine

TITLE: CEO		TITLE: Secretary

DATE: 2-20-06		DATE: 2-27-06

List of attachments included as part of this Amendment:


Specify Type	Number	Description

Attachment	VIII-A	2005/2006 HMO Rates (3 pages)

AHCA Contract No. FA523, Amendment No. 10, Page 3 of 3

ATTACHMENT VIII-A
2005/2006 MEDICAID HMO CAPITATION RATES
By Area, Age and Eligibility Category
Effective from July 1, 2005 thru June 30, 2006

TABLE 1


General Rates:																																	Effect from July 1, 05-Dec. 31, 05						Effect from Jan. 1, 06 - June 30, 06
									TANF														SSI-NO-MEDICARE										SSI-B		SSI-AB				SSI-B		SSI-AB
Area	BTHMO+2MC		3MO-11MO		AGE (1-5)		AGE (6-13)		AGE (14-20)				AGE (21-54)				AGE (55+)		BTHMO+2MC		3MO-11MO		AGE (1-5)		AGE(6-13)		AGE (14-20)		AGE (21-54)		AGE (55+)				AGE (65-)		AGE(65+)				AGE (65-)		AGE (65+)
									Female		Male		Female		Male
01		856.86		169.63		82.99		52.46		116.16		58.88		223.51		144.11		299.66		8,379.19		1,456.16		373.32		192.70		211.00		636.93		598.54		359.76		314.95		219.52		213.89		77.80		67.94
02		856.85		169.63		82.99		52.46		116.16		58.88		223.51		144.11		299.66		8,379.19		1,456.16		373.32		192.70		211.00		636.93		598.84		359.76		314.85		219.52		213.89		77.80		67.94
03		956.50		190.36		93.47		59.66		130.82		66.71		252.75		163.57		340.95		8,796.55		1,536.62		394.23		205.64		225.15		679.21		639.39		347.95		292.11		203.81		229.06		75.70		66.16
04		877.98		175.54		86.37		56.47		120.97		62.05		234.40		152.22		317.36		8,571.65		1,495.56		363.99		199.57		218.39		659.82		620.93		333.59		294.49		205.57		207.10		77.20		67.39
05		919.97		183.42		90.13		57.68		126.15		64.46		244.02		158.18		328.69		9,248.01		1,615.40		414.34		216.54		236.27		713.54		671.66		327.78		311.44		217.30		209.72		74.11		64.73
06		839.69		168.12		82.82		53.24		115.99		58.58		224.94		146.07		306.02		8,536.48		1,494.27		383.80		201.12		219.94		663.51		624.96		318.14		263.93		198.16		200.02		66.93		60.15
07		894.04		178.56		87.80		58.33		122.97		63.04		238.18		154.51		322.34		8,976.51		1,573.97		404.61		212.74		232.25		701.12		661.11		306.90		264.61		198.64		199.32		72.42		63.28
08		765.52		156.85		77.12		49.44		107.84		56.29		209.14		136.62		282.90		8,247.93		1,440.20		369.54		192.51		211.13		636.41		599.00		306.59		265.63		201.43		185.30		69.18		60.36
09		850.65		169.56		83.32		53.28		116.63		59.62		225.69		148.30		304.86		8,123.67		1,599.06		410.92		216.11		235.92		711.70		670.95		286.69		317.25		221.58		179.44		76.11		66.48
10		864.17		170.66		84.11		54.07		117.82		60.56		228.53		148.48		309.60		11,134.67		1,955.16		602.14		254.85		289.16		873.08		823.33		316.19		341.03		235.55		205.90		81.99		71.69
11		1,110.67		220.94		108.54		69.06		151.73		77.37		293.07		189.70		396.11		12,135.43		2,122.04		545.24		284.82		311.87		940.59		885.79		450.68		420.85		294.28		269.25		112.55		95.31

TABLE 2


General + Transportation Rates:																																	Effect from July 1, 05 - Dec. 31, 05						Effect from Jan. 1, 06 - June 30, 06

	TANF																						SSI-NO-MEDICARE										SSI-B		SSI-AB				SSI-B		SSI-AB
Area	THMO+2M0		3MO-11MO		AGE (1-5)		AGE (6-13)		AGE (14-20)				AGE (21-54)				AGE (55+)		THMO+2MO		3MO-11MO		AGE (1-6)		AGE (6-13)		AGE (14-20)		AGE (21-54)		AGE (55+)				AGE (65-)		AGE (65+)				AGE (65-)		AGE (65+)
									Female		Male		Female		Male
01		859.90		170.76		83.89		53.10		117.81		59.91		226.17		145.81		302.65		8,391.86		1,468.01		360.72		194.81		214.64		651.77		609.36		374.05		331.44		226.36		228.18		94.29		74.78
02		859.90		170.76		83.89		53.10		117.81		59.91		226.17		145.61		302.65		8,391.86		1,468.01		360.72		194.81		214.64		651.77		609.36		374.05		331.44		226.36		228.18		94.29		74.78
03		959.98		191.56		94.50		60.41		132.70		67.68		255.60		165.52		344.37		8,811.57		1,550.92		403.17		208.19		229.78		697.16		652.10		358.59		316.61		213.61		239.70		99.10		75.86
04		880.32		176.41		87.06		55.97		122.24		62.84		236.46		153.53		319.66		8,558.73		1,511.34		393.66		202.38		223.50		679.81		634.95		340.18		317.93		215.29		213.69		100.94		77.11
05		922.10		184.21		90.75		58.14		127.30		66.18		245.89		159.37		331.78		8,257.23		1,624.00		419.72		218.07		239.06		724.34		679.53		333.32		325.59		223.17		216.28		86.26		70.60
06		842.31		169.02		83.53		53.76		117.30		60.38		227.06		147.42		307.40		8,546.66		1,504.05		389.72		202.87		223.11		675.78		633.85		322.90		298.45		204.18		204.78		83.45		66.17
07		896.76		179.20		88.31		56.70		123.90		63.62		239.68		155.47		324.02		8,987.84		1,584.55		411.12		214.63		235.67		714.39		670.51		314.35		301.66		205.65		204.77		89.57		70.37
08		786.64		158.01		78.04		50.11		109.62		66.34		211.86		137.36		285.97		8,269.67		1,451.18		376.39		194.48		214.68		650.16		608.74		316.39		304.12		207.55		195.10		84.67		86.75
09		853.54		170.64		84.16		53.90		118.15		60.59		228.21		147.91		307.69		9,136.00		1,610.56		416.13		216.16		239.64		726.15		681.19		293.10		336.49		229.56		183.85		95.35		74.46
10		856.36		171.67		84.76		54.54		119.01		61.30		230.45		149.70		311.95		11,151.24		1,670.64		511.81		267.61		294.16		892.47		837.08		322.46		363.21		247.75		212.17		104.17		80.79
11		1,112.08		221.47		108.96		69.38		152.49		77.84		294.30		190.48		396.50		12,145.44		2,131.36		551.08		286.49		314.69		962.30		894.10		455.34		433.98		299.72		273.91		125.86		103.75

TABLE 3


General + Dental Rates:																															Effect from July 1, 05 - Dec. 31, 05								Effect from Jan. 1, 06-June 30, 06
	TANF																						SSI-NO-MEDICARE										SSI-B		SSI-AB				SSI-B		SSI-AB
Area	THMO+2M0		3MO-11MO		AGE (1-6)		AGE (6-13)		AGE (14-20)				AGE (21-54)				AGE (55+)		THMO+2MO		3MO-11MO		AGE (1-5)		AGE (6-13)		AGE (14-20)		AGE (21-54)		AGE (55+)				AGE (65-)		AGE (65+)				AGE (65-)		AGE (65+)
									Female		Male		Female		Male
01		856.85		169.64		85.68		57.82		122.00		63.64		224.53		144.95		300.28		8,379.19		1,456.20		375.81		196.65		214.57		638.22		599.71		359.86		315.91		219.89		213.99		78.76		66.31
02		856.85		169.64		86.68		57.82		122.00		63.64		224.53		144.95		300.28		8,379.19		1,456.20		375.81		196.65		214.57		638.22		599.71		359.86		315.91		219.89		213.99		78.76		66.31
03		956.50		190.37		96.77		66.24		137.98		72.54		258.08		166.32		342.99		8,796.55		1,536.66		397.67		211.11		230.10		681.91		641.21		349.31		294.26		204.63		230.42		77.85		66.98
04		877.98		175.55		88.68		60.09		125.99		66.14		237.63		164.89		319.33		8,571.85		1,495.60		366.54		203.61		222.05		662.50		622.74		334.80		286.81		206.45		208.31		79.52		68.27
05		919.98		183.44		93.94		66.28		134.42		71.19		254.18		166.58		335.91		8,248.01		1,615.44		419.19		224.23		243.23		718.05		675.60		332.66		317.69		219.69		214.62		80.36		67.12
06		839.89		168.13		85.94		59.43		122.74		85.05		231.04		151.11		308.75		8,636.48		1,494.30		387.15		206.75		225.03		666.52		628.34		320.73		288.82		200.03		202.61		73.82		62.02
07		894.04		178.57		90.51		61.74		128.65		67.53		243.93		159.26		325.86		8,976.51		1,574.00		407.86		218.05		237.05		704.74		663.55		310.08		287.80		159.80		200.50		73.71		64.52
08		785.52		156.86		79.85		54.89		113.87		60.13		214.88		140.36		286.42		8,247.93		1,440.22		372.40		197.06		215.24		641.03		602.12		309.05		292.56		202.94		187.76		73.11		61.87
09		850.66		169.68		86.88		60.40		124.36		65.93		229.41		149.37		307.13		9,123.67		1,599.08		414.10		221.16		240.49		714.60		672.91		269.96		319.90		222.59		180.71		78.76		67.49
10		854.17		170.87		87.29		60.49		124.73		66.19		231.56		150.99		311.65		11,134.67		1,955.21		606.08		271.11		294.81		876.08		826.36		317.65		344.02		239.70		207.36		64.98		72.74
11		1,110.68		220.96		112.49		76.98		180.31		64.36		296.12		192.22		396.87		12,136.43		2,122.07		649.62		291.76		315.16		943.63		887.86		462.12		423.86		295.43		270.59		115.56		99.46

AHCA Contract No. FA523, Attachment VIII-A, Page 1 of 3

TABLE 4


General + Mental Health Rates:
																																			Effect from July 1, 05 - Dec. 31, 05						Effect from Jan. 1, 06 - June 30, 06
	TANF																								SSI-NO-MEDICARE										SSI-B		SSI-AB				SSI-B		SSI-AB
Area	BTHMO+2MO		3MO-11MO		AGE (1-5)		AGE (6-13)		AGE (14-20)					AGE (21-54)					AGE (55+)		BTHMO+2MO		3MO-11MO		AGE (1-5)		AGE (6-13)		AGE (14-20)		AGE (21-54)		AGE (55+)				AGE (65-)		AGE (65+)				AGE (65-)		AGE (65+)
										Female		Male			Female		Male
01		856.86		169.64		84.58		64.23			128.68		71.38			227.66		148.26		303.38		5,379.21		1,456.20		384.40		263,28		284.40		732.06		631.82		367.49		331.54		236.11		221.62		94.39		84.63
02		856.87		169.66		85.36		69.26			128.93		71.65			226.66		147.16		302.78		8,379.20		1,466.19		388.93		276.27		264.36		690.26		621.15		360.78		328.39		232.86		234.92		91.24		61.38
03		956.61		190.37		94.52		67.12			136.49		72.38			254.10		164.92		342.33		6,796.66		1,536.63		401.17		243.67		248.87		702.91		649.30		368.64		299.65		211.36		237.65		83.24		73.70
04		877.99		176.66		87.58		63.92			127.38		68.47			236.93		153.75		318.93		8,571.86		1,495.69		394.00		254.46		252.62		694.02		836.24		342.17		311.98		223.04		215.68		94.67		84.86
05		919.98		183.43		91.16		64.87			131.62		69.93			246.33		159.49		331.03		9,248.02		1,615,41		420.86		262.27		266.55		735.60		681.19		332.63		321.24		227.10		214.69		83.91		74.53
06		839.91		168.14		84.80		87.94			131.69		76.16			230.12		161.25		309,66		8,536.50		1,494.29		383.28		262.76		264.04		746.69		853.76		319.38		288.23		202.46		201.26		73.23		84.45
07		894.06		178.67		89.54		68.84			132.32		72.39			240.41		166.74		324.62		8,976.52		1,673.98		414.04		264.97		264.82		733.66		874.72		312.76		296.22		210.26		203.20		84.13		74.97
08		765.63		166.88		76.13		66.61			113.39		60.74			210.44		136.92		284.23		8,247.94		1,440.21		376.25		229.28		234.06		669.32		608.69		313.20		297.40		210.20		191.91		77.96		69.13
09		860.66		169.67		84.46		61.30			122.72		66.71			227.14		147.76		306.35		9,123.68		1,599.07		417.49		252.14		268.39		734.16		680.34		292.37		328.87		233.20		183.12		67.73		78.10
10		864.19		170.66		86.07		67.92			128.34		71.08			231.04		160.99		312.37		11,134.68		1,966.19		610.19		308.82		316.67		900.47		834.79		319.50		346.90		244.42		209.21		87.86		77.46
11		1,110.68		220.95		110.34		81.84			161.42		87.06			295.39		192.02		397.48		12,136.44		2,122.05		664.29		334.42		342.80		971.48		898.72		457.65		426.65		300.08		276.22		118.36		104.11

TABLE 5


General + Mental Health + Dental Rates:
																																		Effect from July 1, 05 - Dec. 31, 05						Effect from Jan. 1, 06 - June 30, 06
	TANF																							SSI-NO-MEDICARE										SSI-B		SSI-AB				SSI-B		SSI-AB
Area	BTHMO+2MO		3MO-11MO		AGE (1-5)		AGE (6-13)		AGE (14-20)					AGE (21-54)				AGE (55+)		BTHMO+2MO		3MO-11MO		AGE (1-5)		AGE (6-13)		AGE (14-20)		AGE (21-54)		AGE (55+)				AGE (65-)		AGE (65+)				AGE (65-)		AGE (65+)
										Female		Male		Female		Male
01		856.86		169.86		87.27		69.60			134.50		76.14		228.68		149.10		304.00		8,379.21		1,456.22		386.89		267.23		287.97		733.35		632.69		367.59		332.50		236.48		221.72		95.35		64.90
02		656.87		169.88		88.05		74.82			134.77		76.41		227.58		148.00		303.40		8,379.20		1,466.21		391.42		282.22		267.93		691.54		622.02		380.89		329.36		233.33		235.02		92.20		81.75
03		956.51		190.36		87.82		73.70			143.85		73.21		267.43		167.67		344.37		8,796.58		1,536.66		404.61		249.14		253.82		705.81		651.12		367.90		301.60		212.17		239.01		86.39		74.52
04		677.99		175.56		89.67		68.54			132.41		72.56		239.16		166.42		320.90		8,671.86		1,495.61		396.55		258.50		266.28		686.70		637.05		343.38		314.26		223.92		216.69		96.99		85.74
05		919.99		183.45		94.96		72.47			139.89		78.66		256.49		187.69		337.26		9,248.02		1,615.46		426.71		259.96		265.51		741.31		884.91		337.63		327.49		229.49		219.49		90.18		76.92
06		839.91		168.15		87.92		74.13			136.34		80.65		236.22		166.29		313.39		8,536.60		1,494.32		396.83		268.38		289.13		751.60		667.14		321.97		293.12		204.33		203.66		76.12		66.32
07		894.05		176.68		92.25		74.05			136.20		77.18		246.16		161.49		326.14		8,976.52		1,674.01		417.39		270.26		269.62		737.28		677.16		313.96		299.51		211.61		204.38		87.42		76.23
08		785.53		156.67		80.66		82.06			119.32		65.68		216.18		141.66		287.76		6,247.94		1,440.23		379.11		233.83		238.17		663.94		611.71		315.68		301.33		211.71		194.37		81.86		70.64
09		850.67		169.69		88.02		68.42			130.47		72.02		230.86		160.62		306.62		9,123.68		1,599.09		420.87		257.19		262.96		737.05		682.30		293.64		331.52		234.21		184.39		90.36		79.11
10		854.19		170.89		89.25		74.28			135.25		76.71		234.07		163.50		314.22		11,134.68		1,956.22		514.10		315.08		322.23		903.47		838.82		320.96		349.89		246.57		210.67		90.86		78.61
11		1,110.69		220.97		114.29		89.72			170.00		94.05		296.44		184.64		399.34		12,135.44		2,122.08		558.67		341.36		349.08		974.53		900.78		459.09		429.56		301.23		277.66		121.36		105.26

TABLE 6


General + Mental Health + Transportation Rates:
																																		Effect from July 1, 06 - Dec. 31, 06						Effect from Jan. 1, 06 - June, 30, 06
	TANF																							SSI-NO-MEDICARE										SSI-B		SSI-AB				SSI-B		SSI-AB
Area	BTHMO+2MO		3MO-11MO		AGE (1-5)		AGE (6-13)		AGE (14-20)					AGE (21-54)				AGE (55+)		BTHMO+2MO		3MO-11MO		AGE (1-5)		AGE (6-13)		AGE (14-20)		AGE (21-54)		AGE (66+)				AGE (65-)		AGE (65+)				AGE (65-)		AGE (65+)
										Female		Male		Female		Male
01		859.91		170.77		85.48		64.88			130.31		72.41		230.32		149.96		306.37		6,391.68		1,468.03		391.80		265.39		268.24		746.90		642.34		381.78		348.03		242.96		235.91		110.88		91.37
02		869.92		170.78		86.26		69.90			130.68		72.88		229.22		148.86		306.77		6,391.87		1,468.02		396.33		280.38		268.20		705.09		631.67		396.08		344.68		239.80		249.21		107.73		68.22
03		959.99		191.67		95.65		67.87			138.37		73.55		257.16		166.87		345.76		8,611.66		1,550.93		410.11		246.22		263.50		720.86		682.01		367.18		323.05		221.05		248.29		106.64		83.40
04		880.33		178.42		68.25		64.42			128.66		69.26		237.96		165.06		321.23		8,588.74		1,611.35		403.87		267.27		257.73		713.61		849.26		348.76		335.40		232.76		222.27		118.11		94.58
05		922.11		184.22		91.78		66.33			132.77		70.66		247.20		160.68		333.12		9,257.24		1,624.01		426.24		263.80		261.34		746.60		888.84		338.19		335.39		232.97		220.15		95.06		80.40
06		842.33		169.04		65.61		68.45			132.90		75.88		232.24		152.60		312.04		8,646.98		1,504.07		398.40		264.50		287.21		758.66		862.46		324.14		302.75		208.48		206.02		87.75		70.47
07		895.76		179.21		90.05		69.01			133.25		72.97		241.91		157.70		326.30		8,687.65		1,684.56		420.65		266.86		268.24		746.93		684.12		318.23		313.37		217.36		208.65		101.28		82.06
08		788.66		168.02		79.05		67.26			116.07		61.79		213.16		138.66		287.30		8,259.66		1,451.17		383.10		231.23		237.61		673.07		616.33		323.00		312.89		216.62		201.71		93.44		75.56
09		863.65		170.66		65.31		61.92			124.27		69.68		229.68		149.36		309.18		9,136.01		1,610.59		424.70		254.19		262.11		748.60		690.58		298.78		348.11		241.18		187.53		106.97		56.08
10		856.38		171.69		86.72		66.39			129.53		71.82		232.96		162.21		314.52		11,151.25		1,970.65		519.53		311.58		321.58		919.86		848.54		325.77		399.08		263.62		215.48		110.04		86.68
11		1,112.09		221.48		110.76		62.14			162.18		87.63		298.62		192.80		398.87		12,145.46		2,131.39		660.13		336.09		346.82		883.20		907.03		462.31		439.76		305.52		280.86		131.46		109.55

AHCA Contract No. FA523, Attachment VIII-A, Page 2 of 3

TABLE 7


General + Dental + Transportation Rates:
																																	Effect from July 1, 06 - Dec. 31, 05						Effect from Jan. 1, 06 - June 30, 06
	TANF																						SSI-NO-MEDICARE										SSI-B		SSI-AB				SSI-B		SSI-AB
Area	THMO+2MO		3MO-11MO		AGE (1-5)		AGE (6-13)		AGE (14-20)				AGE (21-64)				AGE (65+)		THMO+2MO		3MO-11MO		AGE (1-5)		AGE(6-13)		AGE (14-20)		AGE(21-54)		AGE (66+)				AGE (65-)		AGE(66+)				AGE (65-)		AGE (65+)
									Female		Male		Female		Male
01		869.90		170.77		86.68		68.47		123.96		64.67		227.19		146.65		303.27		8,391.86		1,468.03		363.21		198.76		218.41		663.06		610.23		374.15		332.40		226.73		228.28		95.25		75.15
02		869.90		170.77		86.68		56.47		123.65		64.67		227.19		146.65		303.27		8,391.66		1,468.03		363.21		198.76		218.41		653.06		610.23		374.15		332.40		226.73		228.28		96.25		75.16
03		969.88		191.67		97.80		66.99		139.86		73.71		259.13		168.27		346.41		8,811.87		1,650.95		406.61		213.66		234.73		698.86		663.92		359.95		317.66		214.33		241.06		101.26		79.68
04		880.32		176.42		89.37		60.59		127.26		86.93		239.68		156.20		321.63		8,588.73		1,511.36		396.41		206.42		227.16		682.26		636.76		341.38		320.25		216.17		214.90		102.96		77.99
05		922.11		184.23		94.57		66.74		136.67		71.91		266.05		167.77		338.00		9,267.23		1,824.04		424.57		225.76		246.02		729.85		683.26		338.22		331.84		226.56		220.18		94.61		72.99
06		842.31		169.03		88.65		59.94		124.05		66.87		233.16		152.46		311.13		8,546.96		1,504.08		393.27		208.60		226.20		860.79		637.03		325.49		303.34		206.05		207.37		86.34		68.04
07		896.76		179.21		91.02		62.11		129.78		68.41		246.43		160.22		327.54		8,987.84		1,684.58		414.47		219.94		240.47		718.01		672.96		315.53		304.86		206.91		205.96		92.86		71.63
08		788.84		158.02		80.77		56.58		115.55		61.18		217.80		142.10		289.49		8,259.67		1,451.18		379.25		189.01		218.79		664.78		611.86		318.86		308.06		209.36		197.66		88.60		68.29
09		663.65		170.66		67.75		61.02		125.93		66.90		231.93		160.98		309.96		9,136.00		1,610.60		421.31		223.21		244.21		729.05		683.16		294.37		339.14		230.67		185.12		98.00		75.47
10		656.36		171.68		87.94		60.90		126.92		66.93		233.48		152.21		313.80		11,161.24		1,970.67		515.75		273.87		299.62		896.47		839.11		323.92		388.20		248.90		213.63		107.16		81.94
11		1,112.09		221.49		112.91		77.26		161.07		84.83		297.35		193.00		398.36		12,145.44		2,131.41		555.46		283.43		321.17		955.35		898.16		456.78		436.97		300.87		276.35		128.67		104.80

TABLE 8


General + Mental Health + Transportation + Dental Rates:
																																	Effect from July 1, 05 - Dec. 31, 06						Effect from Jan. 1, 06 - June 30, 06
	TANF																						SSI-NO-MEDICARE										SSI-B		SSI-AB				SSI-B		SSI-AB
Area	THMO+2MO		3MO-11MO		AGE (1-5)		AGE (6-13)		AGE (14-20)				AGE (21-54)				AGE(66+)		THMO+2MO		3MO-11MO		AGE (1-5)		AGE (6-13)		AGE (14-20)		AGE (21-54)		AGE (56+)				AGE (66-)		AGE (65+)				AGE (65-)		AGE (65+)
									Female		Male		Female		Male
01		859.91		170.78		86.17		70.26		136.16		77.17		231.34		160.80		306.99		8,391.88		1,468.06		394.29		269.34		291.61		748.19		643.21		381.88		348.99		243.32		236.01		111.64		91.74
02		859.92		170.79		68.95		75.27		136.42		77.44		230.24		149.70		306.39		8,391.87		1,468.04		398.82		284.33		271.77		709.38		832.54		396.18		345.84		240.17		249.31		108.69		86.69
03		969.99		191.68		98.85		74.45		146.53		79.38		260.48		169.62		347.79		8,811.88		1,550.86		413.65		251.69		258.46		723.66		663.83		360.64		325.20		221.87		249.66		108.79		84.22
04		880.33		176.43		90.56		69.04		133.68		73.36		241.21		157.73		323.20		8,588.74		1,611.37		406.42		261.31		261.38		716.49		651.07		349.97		337.72		233.64		223.48		120.43		96.46
05		922.12		164.24		95.59		72.93		141.04		77.38		257.36		169.08		339.34		9,267.24		1,624.06		431.09		261.49		268.30		752.11		692,56		343.09		341.64		235.36		225.05		104.31		82.79
06		842.33		169.05		88.63		74.64		139.86		81.47		238.34		157.64		316.77		6,546.98		1,504.10		402.95		270.13		292.30		763.67		666.63		326.73		307.64		210.35		208.61		92.64		72.34
07		695.76		179.22		92.76		74.42		139.13		77.76		247.66		162.45		328.82		6.887.86		1,684.58		424.00		272.17		273.04		750.55		656.56		319.41		316.66		218.62		209.63		104.57		83.34
08		788.65		158.03		81.78		82.73		121.00		66.63		218.90		143.40		290.82		8,259.68		1,451.19		386.96		236.76		241.72		677.68		621.46		326.46		316.82		218.13		204.17		97.37		77.06
09		853.56		170.67		88.88		69.04		132.02		72.99		233.38		162.43		311.46		9,136.01		1,610.61		427.88		259.24		266.68		751.60		692.54		298.06		360.76		242.19		168.80		108.62		87.09
10		866.36		171.70		89.90		74.76		136.44		77.45		236.99		154.72		316.37		11,151.25		1,970.68		523.77		317.64		327.24		922.88		860.57		327.23		372.07		254.77		218.94		113.03		87.81
11		1,112.10		221.50		114.71		90.02		170.76		94.52		299.67		195.32		400.73		12,145.45		2,131.42		564.51		343.03		352.10		986.25		909.09		463.76		442.77		308.67		282.32		134.47		110.70

AHCA Contract No. FA523, Attachment VIII-A, Page 3 of 3