Amendment No. 6 to Medicaid Reform HMO Contract (AHCA Contract No. FAR001) between State of Florida Agency for Health Care Administration and HealthEase of Florida, Inc.

Summary

This amendment updates the Medicaid Reform HMO contract between the State of Florida's Agency for Health Care Administration and HealthEase of Florida, Inc. Effective September 1, 2007, it replaces Exhibit 5-A with Exhibit 5-B, which sets new capitation rates for certain Medicaid enrollees in specified Florida counties. All contract terms not changed by this amendment remain in effect. The amendment is only valid if all previous amendments have been executed.

EX-10.3 4 exhibit10-3.htm AMENDMENT NO. 6 TO FAR001 exhibit10-3.htm

Back to Form 8-K
Exhibit 10.3
 
 
Medicaid Reform HMO Contract
HealthEase of Florida, Inc. 

AHCA CONTRACT NO. FAR001
AMENDMENT NO. 6


THIS CONTRACT, entered into between the STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, hereinafter referred to as the “Agency,” and HEALTHEASE OF FLORIDA, INC., hereinafter referred to as the “Vendor,” is hereby amended as follows:

 
1.
Effective September 1, 2007, Attachment I, Scope of Services, is hereby amended to include Exhibit 5-B, attached hereto and made a part of the Contract. All references in the Contract to Exhibit 5-A, shall hereinafter instead refer to Exhibit 5-B.

All provisions in the Contract and any attachments thereto in conflict with this Amendment shall be and are hereby changed to conform with this Amendment.

All provisions not in conflict with this Amendment are still in effect and are to be performed at the level specified in the Contract

This Amendment, and all its attachments, is hereby made part of the Contract.

This Amendment cannot be executed unless all previous Amendments to this Contract have been fully executed.

IN WITNESS WHEREOF, the parties hereto have caused this two (2) page Amendment (including all attachments) to be executed by their officials thereunto duly authorized.


HEALTHEASE OF FLORIDA, INC.
STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION
SIGNED BY:   /s/ Todd S. Farha
SIGNED BY: /s/ Andrew C. Agwunobi
NAME: Todd S. Farha                                
NAME:  Andrew C. Agwunobi, M.D.
TITLE:  President and CEO
TITLE:   Secretary
DATE:   12/7/07                      
DATE:  12/10/07                      
   

List of Attachments/Exhibits included as part of this Amendment:
Specify Type
Letter/ Number
Description
Exhibit
5-B
Capitation Rates SSI Medicare Part B Only and SSI Medicare Parts A and B Enrollees for All Medicaid Reform Counties (1 Page)
     

 
REMAINDER OF THIS PAGE INTENTIONALLY LEFT BLANK

AHCA Contract No. FAR001, Amendment No. 6, Page 1 of 1
 

EXHIBIT 5 - B
CAPITATION RATES
SSI MEDICARE PART B ONLY
AND
SSI MEDICARE PARTS A AND B ENROLLEES
FOR ALL MEDICAID REFORM COUNTIES

 
 
TABLE 4


Area:  4
County:
 Duval, Baker, Clay and Nassau  

ESTIMATED HEALTH PLAN RATES (NOT FOR USE UNLESS APPROVED BY CMS)
 
 
Under Age 65
Age 65 & Over
SSI/Parts A & B
$159.09
$107.50
SSI/Part B Only
$368.77
$368.77

 
 Area: 10  County: Broward
 
ESTIMATED HEALTH PLAN RATES (NOT FOR USE UNLESS APPROVED BY CMS)
 
 
Under Age 65
Age 65 & Over
SSI/Parts A & B
$151.52
$102.61
SSI/Part B Only
$248.51
$248.51


REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
 
 
AHCA Contract No. FAR001, Exhibit 5-B, Page 1 of 1