Amendment No. 3 to Contract YH04-0001-03 Between Arizona Health Care Cost Containment System and Health Choice Arizona
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Summary
This amendment updates the contract between the Arizona Health Care Cost Containment System (AHCCCS) and Health Choice Arizona to correct and revise capitation rates, specifically adjusting the Maternity Delivery Payment. The changes address previous errors in rate calculations and rounding, with new rates provided for various counties and member categories. All other terms of the original contract remain unchanged. The amendment is effective as of October 1, 2003, and requires signatures from both parties to confirm agreement.
EX-10.19 9 g86118exv10w19.txt EX-10.19 AMENDMENT NO.3 EXHIBIT 10.19 ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM ADMINISTRATION DIVISION OF BUSINESS AND FINANCE CONTRACT AMENDMENT Page 1 of 1
5. CONTRACTOR/PROVIDER NAME AND ADDRESS: HEALTH CHOICE ARIZONA 1600 WEST BROADWAY, SUITE 260 TEMPE, ARIZONA ###-###-#### 6. PURPOSE: To revise capitation rates contained in Section B. 7. THE CONTRACT REFERENCED ABOVE IS AMENDED AS FOLLOWS: The purpose of this amendment is to adjust the Maternity Delivery Payment. In Amendment 02, the summary rate sheet by GSA had the incorrect rate stated; and, the Final Awarded Rate sheets had a rounding error in the reinsurance offset line. These errors have been corrected and are reflected in the attached revised capitation rates. All other terms and conditions of the contract remains the same. Note: Please sign, date and return one original to: Diane E. Harnisch, CPPB Contract Management Specialist AHCCCS Contracts and Purchasing 701 E. Jefferson, MD5700 Phoenix, Arizona 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. NAME OF CONTRACTOR: 10. ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM Health Choice Arizona SIGNATURE OF AUTHORIZED INDIVIDUAL: SIGNATURE: /s/ Carolyn Rose /s/ MICHAEL VEIT ---------------- ----------------- TYPED NAME: TYPED NAME: Carolyn Rose MICHAEL VEIT TITLE: TITLE: Chief Executive officer Contracts and Purchasing Administrator DATE DATE: September 10, 2003 AS OF: 10/1/2003 PLAN: HEALTH CHOICE ARIZONA ACUTE GSA: 4 COUNTY: APACHE/COCONINO/MOHAVE/NAVAJO
AS OF: 10/1/2003 PLAN: HEALTH CHOICE ARIZONA ACUTE GSA: 8 COUNTY: GILA/PINAL
AS OF: 10/1/2003 PLAN: HEALTH CHOICE ARIZONA ACUTE GSA: 10 COUNTY: PIMA
AS OF: 10/1/2003 PLAN: HEALTH CHOICE ARIZONA ACUTE GSA: 12 COUNTY: MARICOPA
AZ-AHCCCS PROPRIETARY AND CONFIDENTIAL FINAL AWARDED RATE - CYE04 - HEALTH CHOICE: GSA 4 - (EFFECTIVE 10/01/03) PERCENT CHANGE DUE TO PROGRAMMATIC ADJUSTMENTS
PERCENT CHANGE DUE TO PROGRAMMATIC ADJUSTMENTS
1. The KidsCare age cohort includes individuals 14 to 18 years of age, while the TANF rate cell includes 14 - 44. 2. The adjustment is multiplicative, not additive. 3. The Maternity Delivery Payment does not have a reinsurance component built directly into the rate. However, it is indirectly affected by choosing a different deductible level because the TANF 14-44 female rate is applied as an 8-month offset to the Maternity Delivery Payment, and the female rate is directly affected by a new reinsurance election. Mercer Government Human Services Consulting [ILLEGIBLE] 1 of 8 AZ-AHCCCS PROPRIETARY AND CONFIDENTIAL FINAL AWARDED RATE - CYE04 - HEALTH CHOICE: GSA 4 - (EFFECTIVE 10/01/03) PMPM CHANGE DUE TO PROGRAMMATIC ADJUSTMENTS
PMPM CHANGE DUE TO PROGRAMMATIC ADJUSTMENTS
1. The kidsCare age cohort covers individuals 14 - 18 years of age, while the TANF rate cell includes 14 - 44. 2. The Maternity Delivery Payment does not have a reinsurance component built directly into the rate. However, it is indirectly affected by choosing a different deductible level because the TANF 14-44 female rate is applied as an 8-month offset to the Maternity Delivery Payment, and the female rate is directly affected by a new reinsurance election. Mercer Government Human Services Consulting [ILLEGIBLE] 2 of 8 AZ-AHCCCS PROPRIETARY AND CONFIDENTIAL FINAL AWARDED RATE - CYE04 - HEALTH CHOICE: GSA 8 - (EFFECTIVE 10/01/03) PERCENT CHANGE DUE TO PROGRAMMATIC ADJUSTMENTS
PERCENT CHANGE DUE TO PROGRAMMATIC ADJUSTMENTS
1. The KidsCare age cohort includes Individuals 14 to 18 years of age, while the TANF rate cell includes 14 - 44. 2. The adjustment is multiplicative, not additive. 3. The Maternity Delivery Payment does not have a reinsurance component built directly into the rate. However, it is indirectly affected by choosing a different deductible level because the TANF 14-44 female rate is applied as an 8-month offset to the Maternity Delivery Payment, and the female rate is directly affected by a new reinsurance election. Mercer Government Human Services Consulting [ILLEGIBLE] 3 of 8 AZ-AHCCCS PROPRIETARY AND CONFIDENTIAL FINAL AWARDED RATE - CYE04 - HEALTH CHOICE: GSA 8 - (EFFECTIVE 10/01/03) PMPM CHANGE DUE TO PROGRAMMATIC ADJUSTMENTS
PMPM CHANGE DUE TO PROGRAMMATIC ADJUSTMENTS
1. The KidsCare age cohort covers Individuals 14-18 years of age while the TANF rate cell includes 14 - 44. 2. The Maternity Delivery Payment does not have a reinsurance component built directly into the rate. However, it is indirectly affected by choosing a different deductible level because the TANF 14-44 female rate is applied as an 8-month offset to the Maternity Delivery Payment, and the female rate is directly affected by a new reinsurance election. Mercer Government Human Services Consulting [ILLEGIBLE] 4 of 8 AZ-AHCCCS PROPRIETARY AND CONFIDENTIAL FINAL AWARDED RATE-CYE04 -HEALTH CHOICE: GSA 10 PIMA ONLY- (EFFECTIVE 10/01/03) PERCENT CHANGE DUE TO PROGRAMMATIC ADJUSTMENTS
PERCENT CHANGE DUE TO PROGRAMMATIC ADJUSTMENTS
1. The KidsCare age cohort includes individuals 14 to 18 years of age, while the TANF rate cell includes 14 - 44. 2. The adjustment is multiplicative, not additive. 3. The Maternity Delivery Payment does not have a reinsurance component built directly into the rate. However, it is indirectly affected by choosing a different deductible level because the TANF 14-44 female rate is applied as an 8-month offset to the Maternity Delivery Payment, and the female rate is directly affected by a new reinsurance election. Mercer Government Human Services Consulting [ILLEGIBLE] 5 of 8 AZ-AHCCCS PROPRIETARY AND CONFIDENTIAL FINAL AWARDED RATE - CYE04 - HEALTH CHOICE: GSA 10 PIMA ONLY - (EFFECTIVE 10/01/03) PMPM CHANGE DUE TO PROGRAMMATIC ADJUSTMENTS
PMPM CHANGE DUE TO PROGRAMMATIC ADJUSTMENTS
1. The KidsCare age cohort covers Individuals 14 - 18 years of age while the TANF rate cell includes 14 - 44. 2. The Maternity Delivery Payment does not have a reinsurance component built directly into the rate. However, it is indirectly affected by choosing a different deductible level because the TANF 14-44 female rate is applied as an 8-month offset to the Maternity Delivery Payment, and the female rate is directly affected by a new reinsurance election. Mercer Government Human Services Consulting [ILLEGIBLE] 6 of 8 AZ-AHCCCS PROPRIETARY AND CONFIDENTIAL FINAL AWARDED RATE - CYE04 - HEALTH CHOICE: GSA 12- (EFFECTIVE 10/01/03) PERCENT CHANGE DUE TO PROGRAMMATIC ADJUSTMENTS
PERCENT CHANGE DUE TO PROGRAMMATIC ADJUSTMENTS
1. The KidsCare age cohort includes Individuals 14 to 18 years of age, while the TANF rate cell includes 14 - 44. 2. The adjustment is multiplicative, not additive. 3. The Maternity Delivery Payment does not have a reinsurance component built directly into the rate. However, it is indirectly affected by choosing a different deductible level because the TANF 14-44 female rate is applied as an 8-month offset to the Maternity Delivery Payment, and the female rate is directly affected by a new reinsurance election. Mercer Government Human Services Consulting [ILLEGIBLE] 7 of 8 AZ-AHCCCS PROPRIETARY AND CONFIDENTIAL FINAL AWARDED RATE - CYE04 - HEALTH CHOICE: GSA 12 - (EFFECTIVE 10/01/03) PMPM CHANGE DUE TO PROGRAMMATIC ADJUSTMENTS
PMPM CHANGE DUE TO PROGRAMMATIC ADJUSTMENTS
1. The KidsCare age cohort covers individuals 14 - 18 years of age while the TANF rate cell includes 14 - 44. 2. The Maternity Delivery Payment does not have a reinsurance component built directly into the rate. However, it is indirectly affected by choosing a different deductible level because the TANF 14-44 female rate is applied as an 8-month offset to the Maternity Delivery Payment, and the female rate is directly affected by a new reinsurance election. Mercer Government Human Services Consulting [ILLEGIBLE] 8 of 8