Financial Statements
EX-10.2 5 c12010exv10w2.htm EXHIBIT 10.2 Exhibit 10.2
EXHIBIT 10.2
 | ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM ADMINISTRATION DIVISION OF BUSINESS AND FINANCE SECTION A: CONTRACT |
1 . | AMENDMENT | 2. | CONTRACT | 3. | EFFECTIVE DATE OF | 4. | PROGRAM | |||||||||||||
| NUMBER: | NO.: | AMENDMENT: | ||||||||||||||||||
| 12 | YH09-0001-07 | October 1, 2009 | DHCM — ACUTE |
5. CONTRACTOR’S NAME AND ADDRESS:
VHS Phoenix Health Plan, LLC
7878 N. 16th St., Suite 105
Phoenix, AZ 85020
7878 N. 16th St., Suite 105
Phoenix, AZ 85020
6. PURPOSE OF AMENDMENT: To amend Section B, Capitation Rates, effective October 1, 2009 through September 30, 2010.
7. THE CONTRACT REFERENCED ABOVE FOLLOWS
To amend Section B, Capitation Rates, effective October 1, 2009 through September 30, 2010.
NOTE: Please sign, date, and return executed file by E-Mail to: Mark Held at ***@***
Sr. Procurement Specialist
AHCCCS Contracts and Purchasing
and Stewart McKenzie at
***@***
AHCCCS Contracts and Purchasing
and Stewart McKenzie at
***@***
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 REPRESENTATIVE: | 10. SIGNATURE OF AHCCCSA CONTRACTING OFFICER: | |
/s/ Nancy Novick | /s/ Michael Veit | |
TYPED NAME: NANCY NOVICK | TYPED NAME: MICHAEL VEIT | |
TITLE: CHIEF EXECUTIVE OFFICER | TITLE: CONTRACTS & PURCHASING ADMINISTRATOR | |
DATE: 11/5/10 | DATE: OCT 26 2010 |
ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM
REVISED CAPITATION RATE SUMMARY — ACUTE RATES
Phoenix Health Plan
10/1/09-9/30/10
REVISED CAPITATION RATE SUMMARY — ACUTE RATES
Phoenix Health Plan
10/1/09-9/30/10
| TANF | TANF | TANF | TANF | TANF | SSI | SSI | ||||||||||||||||||||||||||
| Title XIX and KidsCare Rates 1: | <1, M/F | 1-13, M/F | 14-44, F | 14-44, M | 45+, M/F | w/ Med | w/o Med | Non-MED | ||||||||||||||||||||||||
4 Apache/Coconino/Mohave/Navajo | $ | 461.60 | $ | 111.96 | $ | 267.24 | $ | 150.93 | $ | 395.92 | $ | 153.53 | $ | 717.85 | $ | 482.71 | ||||||||||||||||
6 Yavapai | $ | 509.93 | $ | 118.24 | $ | 282.23 | $ | 184.89 | $ | 442.03 | $ | 145.89 | $ | 786.83 | $ | 602.35 | ||||||||||||||||
8 Gila/Pinal | $ | 562.01 | $ | 108.28 | $ | 256.33 | $ | 176.97 | $ | 372.20 | $ | 136.42 | $ | 756.92 | $ | 476.08 | ||||||||||||||||
10 Pima | $ | 461.72 | $ | 94.10 | $ | 216.44 | $ | 114.09 | $ | 359.91 | $ | 120.13 | $ | 792.17 | $ | 410.62 | ||||||||||||||||
12 Maricopa | $ | 492.87 | $ | 116.46 | $ | 240.02 | $ | 150.56 | $ | 401.09 | $ | 150.47 | $ | 690.42 | $ | 544.37 | ||||||||||||||||
| 1. | Rates have been adjusted for $35,000 Reinsurance Deductible |
