Fourth Amendment to Capitation Rate Agreement between Arizona Health Care Cost Containment System and VHS Phoenix Health Plan, LLC

Contract Categories: Business Finance › Modification Agreements
Summary

This amendment updates the contract between the Arizona Health Care Cost Containment System (AHCCCS) and VHS Phoenix Health Plan, LLC to revise the capitation rates for acute care services provided under the state’s Medicaid and KidsCare programs. The new rates are effective for specific periods between October 1, 2008, and September 30, 2009, and apply to various counties and member categories. All other terms of the original contract remain unchanged. Both parties have signed to confirm the amendment.

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EX-10.57 2 exhibit10_57.htm VANGUARD HEALTH SYSTEMS, INC.

EXHIBIT 10.57

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


1. AMENDMENT NUMBER:
    4

2.  CONTRACT NO.:
     YH09-0001-07

3.  EFFECTIVE DATE OF AMENDMENT:
     August 1, 2009

4.  PROGRAM:
     DHCM - ACUTE


5. CONTRACTOR/PROVIDER NAME AND ADDRESS:

VHS Phoenix Health Plan, LLC
7878 N. 16th Street, Suite 105
Phoenix, Arizona  85020


6. PURPOSE OF AMENDMENT:  To amend Section B, Capitation Rates, effective October 1, 2008 and May 1, 2009.

7.

 

THE CONTRACT REFERENCED ABOVE FOLLOWS

 

 

 

 

 

 

 

 

 

To amend Section B, Capitation Rates, effective October 1, 2008 and May 1, 2009.

 

 

NOTE:  Please sign and date all copies and then return one executed original to:                    Mark Held
                                                                                                                                Sr. Procurement Specialist
                                                                                                                                AHCCS Contracts
                                                                                                                                701 E. Jefferson St., MD 5700
                                                                                                                                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 REPRESENTATIVE:

 

10.  SIGNATURE OF AHCCCSA CONTRACTING OFFICER:

     /a/ Nancy Novick

 

       /s/ Michael Veit

 

 

 

TYPED NAME:      NANCY NOVICK

 

MICHAEL VEIT

TITLE:                    CHIEF EXECUTIVE OFFICER

 

CONTRACTS & PURCHASING ADMINISTRATOR

DATE: 7/7/09

 

DATE: JUL 02 2009

Contract Rates 27 - PHP

ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM
REVISED CAPITATION RATE SUMMARY – ACUTE RATES
Phoenix Health Plan
10/01/2008-9/30/2009

 

Effective 10/01/08-4/30/09

Title XIX and KidsCare Rates:

TANF
<1, M/F

TANF
1-13, M/F

TANF
14-44, F

TANF
14-44, M

TANF
45+, M/F

SSI
w/ Med

SSI
w/o Med

Non-MED

4

Apache/Coconino/Mohave/Navajo

$488.98

$111.67

$267.16

$156.50

$391.07

$155.98

$744.82

$556.47

6

Yavapai

$512.27

$116.16

$272.65

$183.26

$420.26

$143.44

$750.57

$627.84

8

Gila/Pinal

$582.27

$108.67

$259.14

$175.82

$367.14

$145.38

$746.22

$494.78

10

Pima

$487.79

$100.17

$235.04

$126.60

$395.59

$147.19

$769.81

$467.59

12

Maricopa

$546.62

$115.95

$237.49

$144.45

$407.72

$152.99

$712.79

$591.53

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Effective 5/01/09-9/30/09

Title XIX and KidsCare Rates:

TANF
<1, M/F

TANF
1-13, M/F

TANF
14-44, F

TANF
14-44, M

TANF
45+, M/F

SSI
w/ Med

SSI
w/o Med

Non-MED

4

Apache/Coconino/Mohave/Navajo

$484.41

$110.52

$263.94

$154.94

$386.38

$153.61

$739.59

$551.12

6

Yavapai

$507.50

$114.86

$269.41

$181.45

$415.33

$141.37

$745.38

$621.98

8

Gila/Pinal

$580.79

$108.46

$258.07

$175.32

$365.52

$144.65

$745.28

$492.87

10

Pima

$484.72

$99.43

$233.00

$125.72

$392.29

$145.79

$766.11

$464.33

12

Maricopa

$544.54

$115.27

$236.21

$143.85

$405.69

$152.21

$710.78

$589.23