CONTRACT AMENDMENT

EX-10.1 3 g76274ex10-1.txt CONTRACT AMENDMENT Page 1 of 2 EXHIBIT 10.1 ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM ADMINISTRATION DIVISION OF BUSINESS AND FINANCE [AHCCCS LOGO] SECTION A. CONTRACT AMENDMENT ================================================================================ 1. AMENDMENT 2. CONTRACT 3. EFFECTIVE DATE OF 4. PROGRAM NUMBER: NO.: AMENDMENT: 18 YHS-0001-05 April 1, 2002 OMC ================================================================================ 5. CONTRACTOR'S NAME AND ADDRESS: Health Choice Arizona 1600 W. Broadway, Suite 260 Tempe, AZ ###-###-#### ================================================================================ 6. PURPOSE OF AMENDMENT: To establish new capitation rates for Title XIX Waiver Group effective April 1, 2002. ================================================================================ 7. THE CONTRACT REFERENCED ABOVE IS AMENDED AS FOLLOWS: A. New Capitation rates for Title XIX Waiver Group are changed to the rates provided on page two (2) of this amendment effective April 1, 2002. NOTE: Please sign and date both and then return one to: Michael Veit, MD 5700 AHCCCS Contracts and Purchasing 701 E. Jefferson Street Phoenix AZ 85034 ================================================================================ 8. EXCEPT AS PROVIDED FOR HEREIN, ALL TERMS AND CONDITIONS OF THE ORIGINAL CONTRACT NOT HERETOFORE CHANGED AND/OR AMENDED REMAIN UNCHANGED AND IN FULL EFFECT. IN WITNESS WHEREOF THE PARTIES HERETO SIGN THEIR NAMES IN AGREEMENT ================================================================================ 9. SIGNATURE OF AUTHORIZED 10. SIGNATURE OF AHCCCSA CONTRACTING REPRESENTATIVE: OFFICER: /s/ Greg Martenson / /s/ Carolyn Rose /s/ Michael Veit ================================================================================ TYPE NAME: CAROLYN ROSE MICHAEL VEIT ================================================================================ TITLE: CONTRACTS & PURCHASING CHIEF EXECUTIVE OFFICER ADMINISTRATOR ================================================================================ DATE: DATE: 3/6/02 MAR 01 2002 ================================================================================ Page 2 of 2 ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM CAPITATION RATE SUMMARY - ACUTE RATES Health Choice Arizona CYE '02 (as of 4/01/02) TITLE XIX TITLE XIX RATES: WAIVER GROUP - --------------------------- ------------------- 10 Pima $198.11 12 Maricopa $183.60 PPC RATES: - --------------------------- 10 Pima $174.32 12 Maricopa $170.52