Amendment No. 18 to Contract YH04-0001-06 between Arizona Health Care Cost Containment System and Phoenix Health Plan, LLC

Summary

This contract amendment updates the agreement between the Arizona Health Care Cost Containment System (AHCCCS) and Phoenix Health Plan, LLC, effective April 1, 2008. The amendment revises sections related to payment rates, definitions, program requirements, network standards, assignment algorithms, and grievance procedures. All other terms of the original contract remain unchanged. Both parties have signed to confirm their agreement to these modifications.

EX-10.68 5 exhibit10_68.htm EXHIBIT 10.68

EXHIBIT 10.68

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.

NOTE: Please sign, date and return one original to:
Philip Baldwin
AHCCCS Contracts and Purchasing
701 E Jefferson Street, 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. 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