ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM ADMINISTRATION DIVISION OF BUSINESS AND FINANCE CONTRACT AMENDMENT

1. AMENDMENT NUMBER:
    18

2.  CONTRACT NO.:
     YH04-0001-06

3.  EFFECTIVE DATE OF MODIFICATION:
     April 1, 2008

4.  PROGRAM:
     DHCM-ACUTE

5. CONTRACTOR/PROVIDER NAME AND ADDRESS:

Phoenix Health Plan, LLC
7878 North 16^th Street, Suite 105
Phoenix, Arizona  85020

6. PURPOSE:  To amend Sections B Capitation Rates; Section C, Definitions; Section D, Program Requirements; Section F, Index of Section D; Attachment B, Minimum Network Standards; Attachment G, Auto Assignment Algorithm; and Attachment H(1), Enrollee Grievance System Standards and Policy.

7.

The above referenced contract is amended as follows:

A.

SECTION B, CAPITATION RATES-See Contract B for specifics.

B.

SECTION C, DEFINITIONS-For Liable Party and Third Party Liability

C.

SECTION D, PROGRAM REQUIREMENTS-See Contract Section D. for specifics.

D.

SECTION F, INDEX OF SECTION D-Reserved Section

E.

ATTACHMENT B, MINIMUM NETWORK STANDARDS-Removed reference to Hospital Subcontracting and Reimbursement PILOT Program.

F.

ATTACHMENT G, AUTO ASSIGNMENT ALGORITUM-Added language clarifying algorithm considerations for the end of the Contract term

G.

ATTACHMENT H(1), ENROLLEE GRIEVANCE SYSTEM STANDARDS AND POLICY-Amended #20 to read that all notifications to providers must be in writing.

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:
    Phoenix Health Plan, LLC

10. ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM

SIGNATURE OF AUTHORIZED INDIVIDUAL:
/s/ Nancy Novick                                   
NANCY NOVICK
CHIEF EXECUTIVE OFFICER

SIGNATURE:
/s/ Michael Veit                                       
MICHAEL VEIT
CONTRACTS & PURCHASING ADMINISTRATOR

DATE:  5/5/08

DATE:  APR 23, 2008