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 16th 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 GrievanceSystem 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 BaldwinAHCCCS Contracts and Purchasing701 E Jefferson Street, MD 5700Phoenix, 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 |

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