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ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM ADMINISTRATION
DIVISION OF BUSINESS AND FINANCE
SECTION A: CONTRACT

1.  AMENDMENT
     NUMBER:
            7

2.  CONTRACT NO.:
     YH09-0001-07

3.  EFFECTIVE DATE OF AMENDMENT
      October 1, 2009

4.  PROGRAM
  DHCM - ACUTE

5.  CONTRACTOR'S NAME AND ADDRESS:

VHS Phoenix Health Plan, LLC
7878 N. 16^th St., Suite 105
Phoenix, AZ 85020

6.  PURPOSE OF AMENDMENT:  To amend Section B, Capitation Rates.

7.  THE CONTRACT REFERENCED ABOVE FOLLOWS
     A.            Section B contains revised Capitation Rates (see attached rate sheet.)

NOTE:  Please sign, date, and return executed file by E-Mail to:Mark Held at ***@***
                                                                                                               Sr. Procurement Specialist
                                                                                                               AHCCCS Contracts and Purchasing
                                                                                                               and Georgina Maya 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:
     /s/ Nancy Novick

TYPED NAME:    NANCY NOVICK
TITLE:                    CHIEF EXECUTIVE OFFICER
DATE:                    9/17/09

10.  SIGNATURE OF AHCCCSA CONTRACTING OFFICER:

       /s/ Michael Veit

MICHAEL VEIT

CONTRACTS & PURCHASING ADMINISTRATOR
DATE:    SEP 10 2009