Third Amendment to Capitation Rate Agreement between Arizona Health Care Cost Containment System and VHS Phoenix Health Plan, LLC (May 2009)
This amendment updates the contract between the Arizona Health Care Cost Containment System (AHCCCS) and VHS Phoenix Health Plan, LLC, effective May 1, 2009. It revises the capitation rates—the fixed monthly payments per member—for healthcare services provided under the state’s acute care program through September 30, 2009. All other terms of the original contract remain unchanged. The amendment requires both parties to sign and return the agreement to confirm acceptance of the new rates.
EXHIBIT 10.1
ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM ADMINISTRATION
DIVISION OF BUSINESS AND FINANCE
SECTION A: CONTRACT
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| 2. CONTRACT NO.: | 3. EFFECTIVE DATE OF CONTRACT: | 4. PROGRAM: | |||
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VHS Phoenix Health Plan, LLC | ||||||
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| THE CONTRACT REFERENCED ABOVE FOLLOWS |
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| To amend Section B, Capitation Rates, effective May 1, 2009. | |||
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| NOTE: Please sign and date all copies and then return one executed original to: Mark Held | |||||
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| 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. | |||||
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| 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/ Pat Wathimson for Michael Veit |
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| TYPED NAME: NANCY NOVICK |
| MICHAEL VEIT |
| TITLE: CHIEF EXECUTIVE OFFICER |
| CONTRACTS & PURCHASING ADMINISTRATOR |
| DATE: 4/6/09 |
| DATE: 3-30-09 |
SECTION B: CAPITATION RATES
The Contractor shall provide services as described in this contract. In consideration for these services, the Contractor
will be paid Contractor-specific rates per member per month for the term May 1, 200 through September 30,
2009. See attached revised rates.
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ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM | ||||||||||||
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| Title XIX and KidsCare Rates 1: | TANF | TANF | TANF | TANF | TANF | SSI | SSI | SFP | Maternity | Non-MED | MED | |
| 4 | Apache/Coconino/Mohave/Navajo | $474.47 | $111.58 | $273.18 | $157.95 | $409.52 | $161.19 | $776.11 | $19.02 | $6,248.22 | $578.66 | $1,434.36 |
| 6 | Yavapai | $507.50 | $116.03 | $270.46 | $180.56 | $427.88 | $141.69 | $758.61 | $18.30 | $6,871.52 | $627.38 | $1,160.64 |
| 8 | Gila/Pinal | $578.37 | $108.22 | $256.73 | $172.31 | $358.20 | $139.85 | $737.91 | $12.43 | $6,594.24 | $487.17 | $1,673.46 |
| 10 | Pima | $493.42 | $101.61 | $239.36 | $127.59 | $408.04 | $146.24 | $772.28 | $21.96 | $6,627.59 | $492.92 | $1,356.27 |
| 12 | Maricopa | $550.49 | $117.35 | $241.92 | $151.74 | $422.47 | $158.80 | $749.25 | $18.79 | $6,694.65 | $630.48 | $1,423.69 |
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| PPC Rates: | TANF | TANF | TANF | TANF | TANF | SSI | SSI | Non-MED | MED | |||
| 4 | Apache/Coconino/Mohave/Navajo | $1,190.99 | $62.12 | $264.37 | $215.09 | $439.52 | $135.86 | $405.68 | $1,127.75 | $7,407.25 | ||
| 6 | Yavapai | $1,210.79 | 465.92 | $262.35 | $223.35 | $442.10 | $133.86 | $407.50 | $1.116/81 | $7,418.82 | ||
| 8 | Gila/Pinal | $1,200.37 | $66.67 | $253.25 | $212.60 | $444.30 | $134.33 | $407.29 | $1,100.13 | $7,521.76 | ||
| 10 | Pima | $1,195.05 | $56.40 | $248.23 | $197.36 | $440.40 | $132.96 | $408.89 | $889.79 | $7,402.50 | ||
| 12 | Maricopa | $1,221.70 | $66.27 | $256.92 | $225.36 | $448.09 | $133.45 | $426.87 | $1,323.84 | $7,696.96 | ||
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| Other Rates: | Option 1 | Option 2 | ||||||||||
| 4 | Apache/Coconino/Mohave/Navajo | $40.00 | $40.00 | |||||||||
| 6 | Yavapai | $40.00 | $40.00 | |||||||||
| 8 | Gila/Pinal | $40.00 | $40.00 | |||||||||
| 10 | Pima | $40.00 | $40.00 | |||||||||
| 12 | Maricopa | $40.00 | $40.00 | |||||||||
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1. Rates have been adjusted for $50,000 Reinsurance Deductible
