georgiaamendno7.htm


    Back to Form 8-K

    Exhibit 10.1


    
      AMENDMENT
#7 TO CONTRACT NO. 0654 BETWEEN

    

    
      GEORGIA
DEPARTMENT OF COMMUNITY HEALTH AND

    

    
      WELLCARE
OF GEORGIA, INC.

    

    
      


       

      This
Amendment is between the Georgia Department of Community Health (hereinafter
referred to as "DCH" or the "Department") and WellCare of Georgia, Inc.
(hereinafter referred to as
"Contractor") and is made effective this 23 day of September, 2009 (hereinafter
referred
to as the "Effective Date"). Other than the changes, modifications and additions
specifically articulated in this Amendment #7 to Contract # 0654,
RFP#41900-001-0000000027, the original Contract shall remain in effect and
binding on and against DCH and Contractor. Unless expressly modified or added in
this Amendment #7, the terms and conditions of the original Contract are
expressly incorporated into this Amendment #7 as if completely restated
herein.

    

    
       

      WHEREAS, DCH and Contractor
executed a contract for the provision of services to members of the Georgia
Families Program;

    

    
       

          WHEREAS,
DCH pays Contractor a per member per month capitation rate for each
Georgia Families member enrolled in the Contractor's plan;

    

    
       

         WHEREAS, DCH has
sought permission from the Centers for Medicare and Medicaid Services
(hereinafter referred to as "CMS") to revise the capitation rates payable to
Contractor for State Fiscal Year 2010; and

    

    
       

      WHEREAS, pursuant to Section 32.0, Amendments in
Writing, DCH and Contractor desire to amend the above-referenced Contract
by adding additional funding as set forth below.

    

    
       

      NOW THEREFORE, for and in
consideration of the mutual promises of the Parties, the terms, provisions and
conditions of this Amendment and other good and valuable consideration, the
sufficiency of which is hereby acknowledged, DCH and Contractor hereby agree as
follows:

    

    
       

      
        	
                I.

              	
                Upon
      receiving written notice from CMS indicating that agency's approval of the
      revised capitation
      rates, the parties shall delete the current Attachment H, Capitation
      Payment,
      in its entirety and
      replace it with the new Attachment H, Capitation
      Payment, contained
      at Exhibit 1 to this
      Amendment.

              


      

       

    

    
      
        	
                II.

              	
                DCH
      and Contractor agree that they have assumed an obligation to perform the
      covenants, agreements, duties and obligations of the Contract, as modified
      and amended herein, and agree to abide by all the provisions, terms and
      conditions contained in the Contract as modified and
    amended.

              


      

    

    
       

      
        	
                III.

              	
                This
      Amendment shall be binding and inure to the benefit of the parties hereto,
      their heirs, representatives, successors and assigns. Whenever the
      provisions of this Amendment and the Contract are in conflict, the
      provisions of this Amendment shall take precedence and
      control.

              


      

       

    

    
      Amendment
#7 

      Contract
#0654

      Page
1 of 4

      

        
          
             


          

          
             


            
              

            

          

          
             


          

        

      

    

    
       

    

    
      
        	
                VI.

              	
                It
      is understood by the Parties hereto that, if any part, term, or provision
      of this Amendment or this entire Amendment is held to be illegal or in
      conflict with any law of this State, then DCH, at its sole option, may
      enforce the remaining unaffected portions or provisions of this Amendment
      or of the Contract and the rights and obligations of the parties shall be
      construed and enforced as if the Contract or Amendment did not contain the
      particular part, term or provision held to be
  invalid.

              


      

    

    
      


       

      
        	
                VII.

              	
                This
      Amendment shall become effective as stated herein and shall remain
      effective for so long as the Contract is in
  effect.

              


      

    

    
      


       

      
        	
                VIII.

              	
                This
      Amendment shall be construed in accordance with the laws of the State of
      Georgia.

              


      

    

    
      


       

      
        	
                IX.

              	
                All
      other terms and conditions contained in the Contract and any amendment
      thereto, not amended by this Amendment, shall remain in full force and
      effect.

              


      

    

    
      


       

      - SIGNATURES ON THE FOLLOWING PAGE
-

       

      


    

    


    
      


       

      Amendment
#7 

      Contract
#0654

    

    
      Page 2 of
4

    


    
      
         


      

      
         


        
          

        

      

      
         


      

    


    
      SIGNATURE
PAGE

    

    
       

       

      IN WITNESS WHEREOF, DCH and
Contractor, through their authorized officers and agents, have caused this
Amendment to be executed on their behalf as of the date indicated.

       

    

    
      


       

      GEORGIA
DEPARTMENT OF COMMUNITY HEALTH

    

    
      


      


      


    

    
      	 /s/
      Dr. Rhonda M. Medows, M.D.	 
      	 9/23/09                                         
      
	
              Dr.
      Rhonda M. Medows, M.D.

              
                Commissioner

              

               

            	 
      	
              Date

            


    

    
       

      
 

      


    

    
      	 
      	 
      	 
      
	
              
                WELLCARE
      OF GEORGIA, INC.

              

              
                 

              

            	 
      	
               

            
	
              
                BY:

              

            	
              
                   

              

              
                /s/ Heath
      Schiesser                                           
                  
      

                *
      SIGNATURE

              

            	   
      

              Sep.
      11,
      2009                                 
      

              Date

            
	 
      	
              
                 

                Heath
      Schiesser                                                 
      

                Please
      Print/Type Name Here

              

              
                 

              

            	 
      	 
      
	 
      	 
      	 
      
	 
      	 
      	
              
                AFFIX
      CORPORATE SEAL HERE

                (Corporations
      without a seal, attach 

                a
      Certificate
      of Corporate Resolution)

              

               

            


    

    
      


      


    

    
      	
              ATTEST:

            	 /s/
      Karen Mulroe 	 
      
	 
      	
              **
      SIGNATURE

            	 
      
	 
      	 
      	 
      
	 
      	 Secretary
      	 
      
	 
      	
              
                TITLE

              

               

            	 
      


    

    
      


    

    
      	 
      


    

    
      * Must be
President, Vice President, CEO or Other Authorized Officer 

    

    
      **Must be
Corporate Secretary

    

    
      


      


      Amendment
#7 

      Contract
#0654

    

    
      Page 3 of
4

    


    
      
         


      

      
         


        
          

        

      

      
         


      

    


    
      EXHIBIT
1

       

    

    
      
        CONFIDENTIAL
- NOT FOR CIRCULATION 

        ATTACHMENT
H



      Attachment
H is a table displaying the contracted rates by rate cell for each contracted
region. These rates will be the basis for calculating capitation payments in
each contracted Region.

    

    
      (The
table is displayed on the following page.)

       

      


    

    
      Amendment
#7 

      Contract
#0654

    

    
      Page 4 of
4


        
          
             


          

          
             


            
              

            

          

          
             


          

        



    

    
      WellCare

    

     

     

    
      	
              
                 

                      
      Region                                
      Aid
      Category                                                         Age/Gender
      Group

              

            	
              
                WellCare

                July-September
      2009

              

            	
              
                WellCare

                October
      2009 to June 2010

              

            
	
              
                Atlanta

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                0 -
      2 Months, Male and Female

              

            	
              
                $                         1,646.47

              

            	
              
                $                             1,578.16

              

            
	
              
                Atlanta

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                3-11
      Months, Male and Female

              

            	
              
                $                            181.81

              

            	
              
                $                                174.98

              

            
	
              
                Atlanta

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                1 -
      5 Years, Male and Female

              

            	
              
                $                            122.15

              

            	
              
                $                                117.66

              

            
	
              
                Atlanta

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                6-13
      Years, Male and Female

              

            	
              
                $                            111.06

              

            	
              
                $                                106.90

              

            
	
              
                Atlanta

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                14-20
      Years, Female

              

            	
              
                $                            185.49

              

            	
              
                $                                178.56

              

            
	
              
                Atlanta

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                14-20
      Years, Male

              

            	
              
                $                            132.03

              

            	
              
                $                                127.14

              

            
	
              
                Atlanta

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                21
      - 44 Years, Female

              

            	
              
                $                            317.02

              

            	
              
                $                                305.67

              

            
	
              
                Atlanta

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                21
      -44 Years, Male

              

            	
              
                $                            290.78

              

            	
              
                $                                280.43

              

            
	
              
                Atlanta

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                45+
      Years, Female

              

            	
              
                $                            519.77

              

            	
              
                $                                501.36

              

            
	
              
                Atlanta

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                45+
      Years, Male

              

            	
              
                $                            542.16

              

            	
              
                $                                522.57

              

            
	
              
                Atlanta

              

            	
              
                PeachCare

              

            	
              
                0 -
      2 Months, Male and Female

              

            	
              
                $                            154.40

              

            	
              
                $                                148.62

              

            
	
              
                Atlanta

              

            	
              
                PeachCare

              

            	
              
                3-11
      Months, Male and Female

              

            	
              
                $                            154.40

              

            	
              
                $                                148.62

              

            
	
              
                Atlanta

              

            	
              
                PeachCare

              

            	
              
                1 -
      5 Years, Male and Female

              

            	
              
                $                            113.81

              

            	
              
                $                                109.58

              

            
	
              
                Atlanta

              

            	
              
                PeachCare

              

            	
              
                6-13
      Years, Male and Female

              

            	
              
                $                            114.52

              

            	
              
                $                                110.22

              

            
	
              
                Atlanta

              

            	
              
                PeachCare

              

            	
              
                14
      - 20 Years, Female

              

            	
              
                $                            139.02

              

            	
              
                $                                133.78

              

            
	
              
                Atlanta

              

            	
              
                PeachCare

              

            	
              
                14-20
      Years, Male

              

            	
              
                $                            125.82

              

            	
              
                $                                121.16

              

            
	
              
                Atlanta

              

            	
              
                Breast
      and Cervical Cancer

              

            	
              
                Breast
      and Cervical Cancer

              

            	
              
                $                            996.24

              

            	
              
                $                                960.69

              

            
	
              
                Atlanta

              

            	
              
                Maternity
      Delivery/Kick Payment

              

            	
              
                Maternity
      Delivery/Kick Payment

              

            	
              
                $                         5,828.22

              

            	
              
                $                            5,576.09

              

            
	
              
                Atlanta

              

            	
              
                NICU
      Kick

              

            	
              
                NICU
      Kick

              

            	
              
                $                       89,180.47

              

            	
              
                $                          85,376.23

              

            
	
              
                Central

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                0 -
      2 Months, Male and Female

              

            	
              
                $                         1,675.18

              

            	
              
                $                             1,605.98

              

            
	
              
                Central

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                3-11
      Months, Male and Female

              

            	
              
                $                            185.21

              

            	
              
                $                                178.14

              

            
	
              
                Central

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                1 -
      5 Years, Male and Female

              

            	
              
                $                            122.76

              

            	
              
                $                                118.27

              

            
	
              
                Central

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                6-13
      Years, Male and Female

              

            	
              
                $                            114.59

              

            	
              
                $                                110.40

              

            
	
              
                Central

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                14-20
      Years, Female

              

            	
              
                $                            180.50

              

            	
              
                $                                173.81

              

            
	
              
                Central

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                14-20
      Years, Male

              

            	
              
                $                           127.44

              

            	
              
                $                                122.78

              

            
	
              
                Central

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                21
      - 44 Years, Female

              

            	
              
                $                           311.28

              

            	
              
                $                                300.28

              

            
	
              
                Central

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                21
      - 44 Years, Male

              

            	
              
                $                            299.54

              

            	
              
                $                                288.94

              

            
	
              
                Central

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                45+
      Years, Female

              

            	
              
                $                            598.73

              

            	
              
                $                                577.68

              

            
	
              
                Central

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                45+
      Years, Male

              

            	
              
                $                            708.27

              

            	
              
                $                                682.55

              

            
	
              
                Central

              

            	
              
                PeachCare

              

            	
              
                0 -
      2 Months, Male and Female

              

            	
              
                $                            160.54

              

            	
              
                $                              154.45

              

            
	
              
                Central

              

            	
              
                PeachCare

              

            	
              
                3-11
      Months, Male and Female

              

            	
              
                $                            160.54

              

            	
              
                $                              154.45

              

            
	
              
                Central

              

            	
              
                PeachCare

              

            	
              
                1 -
      5 Years, Male and Female

              

            	
              
                $                            126.61

              

            	
              
                $                              122.02

              

            
	
              
                Central

              

            	
              
                PeachCare

              

            	
              
                6-13
      Years, Male and Female

              

            	
              
                $                            128.54

              

            	
              
                $                                123.91

              

            
	
              
                Central

              

            	
              
                PeachCare

              

            	
              
                14-20
      Years, Female

              

            	
              
                $                            155.64

              

            	
              
                $                                150.03

              

            
	
              
                Central

              

            	
              
                PeachCare

              

            	
              
                14-20
      Years, Male

              

            	
              
                $                            137.34

              

            	
              
                $                                132.43

              

            
	
              
                Central

              

            	
              
                Breast
      and Cervical Cancer

              

            	
              
                Breast
      and Cervical Cancer

              

            	
              
                $                            996.09

              

            	
              
                $                                960.52

              

            
	
              
                Central

              

            	
              
                Maternity
      Delivery/Kick Payment

              

            	
              
                Maternity
      Delivery/Kick Payment

              

            	
              
                $                         5,742.45

              

            	
              
                $                             5,494.02

              

            
	
              
                Central

              

            	
              
                NICU
      Kick

              

            	
              
                NICU
      Kick

              

            	
              
                $                       82,199.07

              

            	
              
                $                           78,693.93

              

            
	
              
                East

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                0-2
      Months, Male and Female

              

            	
              
                $                         1,690.27

              

            	
              
                $                             1,620.66

              

            
	
              
                East

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                3-11
      Months, Male and Female

              

            	
              
                $                            201.57

              

            	
              
                $                                194.06

              

            
	
              
                East

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                1 -
      5 Years, Male and Female

              

            	
              
                $                            129.78

              

            	
              
                $                                125.12

              

            
	
              
                East

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                6-13
      Years, Male and Female

              

            	
              
                $                            110.86

              

            	
              
                $                                106.84

              

            
	
              
                East

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                14-20
      Years, Female

              

            	
              
                $                            202.07

              

            	
              
                $                              194.73

              

            
	
              
                East

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                14-20
      Years, Male

              

            	
              
                $                            118.96

              

            	
              
                $                              114.68

              

            
	
              
                East

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                21
      -44 Years, Female

              

            	
              
                $                            347.60

              

            	
              
                $                              335.32

              

            
	
              
                East

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                21
      -44 Years, Male

              

            	
              
                $                            306.59

              

            	
              
                $                                295.68

              

            
	
              
                East

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                45+
      Years, Female

              

            	
              
                $                            591.28

              

            	
              
                $                                570.54

              

            
	
              
                East

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                45+
      Years, Male

              

            	
              
                $                            713.80

              

            	
              
                $                                688.53

              

            
	
              
                East

              

            	
              
                PeachCare

              

            	
              
                0 -
      2 Months, Male and Female

              

            	
              
                $                            174.78

              

            	
              
                $                                168.29

              

            
	
              
                East

              

            	
              
                PeachCare

              

            	
              
                3-11
      Months, Male and Female

              

            	
              
                $                            174.78

              

            	
              
                $                                168.29

              

            
	
              
                East

              

            	
              
                PeachCare

              

            	
              
                1 -
      5 Years, Male and Female

              

            	
              
                $                            134.56

              

            	
              
                $                                129.75

              

            
	
              
                East

              

            	
              
                PeachCare

              

            	
              
                6-13
      Years, Male and Female

              

            	
              
                $                            123.76

              

            	
              
                $                                119.32

              

            
	
              
                East

              

            	
              
                PeachCare

              

            	
              
                14-20
      Years, Female

              

            	
              
                $                            164.53

              

            	
              
                $                                158.57

              

            
	
              
                East

              

            	
              
                PeachCare

              

            	
              
                14-20
      Years, Male

              

            	
              
                $                            129.92

              

            	
              
                $                                125.18

              

            
	
              
                East

              

            	
              
                Breast
      and Cervical Cancer

              

            	
              
                Breast
      and Cervical Cancer

              

            	
              
                $                         1,003.31

              

            	
              
                $                                967.49

              

            
	
              
                East

              

            	
              
                Maternity
      Delivery/Kick Payment

              

            	
              
                Maternity
      Delivery/Kick Payment

              

            	
              
                $                         5,921.35

              

            	
              
                $                             5,665.19

              

            
	
              
                East

              

            	
              
                NICU
      Kick

              

            	
              
                NICU
      Kick

              

            	
              
                $                       80,632.48

              

            	
              
                $                           77,196.62

              

            
	
              
                North

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                0 -
      2 Months, Male and Female

              

            	
              
                $                         1,790.19

              

            	
              
                $                             1,716.84

              

            


    

    
      


       

      Page 1 of
2

    


    
      
         


      

      
         


        
          

        

      

      
         


      

    


    
      	
                  
      

                   Region    

            	
               

              Aid
      Category

            	
               

              Age/Gender
      Group

            	
               WellCare

                          July-September
      2009              
      

            	 WellCare 

              October
      2009 to June 2010

            
	
              
                North

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                3-11
      Months, Male and Female

              

            	
              
                $                            192.84

              

            	
              
                $                               185.49

              

            
	
              
                North

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                1 -
      5 Years, Male and Female

              

            	
              
                $                            142.26

              

            	
              
                $                               137.04

              

            
	
              
                North

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                6-13
      Years, Male and Female

              

            	
              
                $                            142.91

              

            	
              
                $                               137.68

              

            
	
              
                North

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                14-20
      Years, Female

              

            	
              
                $                            222.25

              

            	
              
                $                               214.02

              

            
	
              
                North

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                14-20
      Years, Male

              

            	
              
                $                            158.97

              

            	
              
                $                               153.20

              

            
	
              
                North

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                21
      - 44 Years, Female

              

            	
              
                $                            403.72

              

            	
              
                $                               389.44

              

            
	
              
                North

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                21
      -44 Years, Male

              

            	
              
                $                            400.10

              

            	
              
                $                               385.65

              

            
	
              
                North

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                45+
      Years, Female

              

            	
              
                $                            658.72

              

            	
              
                $                               635.51

              

            
	
              
                North

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                45+
      Years, Male

              

            	
              
                $                            812.41

              

            	
              
                $                               782.42

              

            
	
              
                North

              

            	
              
                PeachCare

              

            	
              
                0 -
      2 Months, Male and Female

              

            	
              
                $                            167.09

              

            	
              
                $                               160.75

              

            
	
              
                North

              

            	
              
                PeachCare

              

            	
              
                3-11
      Months, Male and Female

              

            	
              
                $                            167.09

              

            	
              
                $                               160.75

              

            
	
              
                North

              

            	
              
                PeachCare

              

            	
              
                1 -
      5 Years, Male and Female

              

            	
              
                $                            123.94

              

            	
              
                $                               119.38

              

            
	
              
                North

              

            	
              
                PeachCare

              

            	
              
                6-13
      Years, Male and Female

              

            	
              
                $                            128.72

              

            	
              
                $                                124.00

              

            
	
              
                North

              

            	
              
                PeachCare

              

            	
              
                14-20
      Years, Female

              

            	
              
                $                            172.01

              

            	
              
                $                               165.66

              

            
	
              
                North

              

            	
              
                PeachCare

              

            	
              
                14-20
      Years, Male

              

            	
              
                $                            138.46

              

            	
              
                $                               133.42

              

            
	
              
                North

              

            	
              
                Breast
      and Cervical Cancer

              

            	
              
                Breast
      and Cervical Cancer

              

            	
              
                $                         1,008.97

              

            	
              
                $                               972.94

              

            
	
              
                North

              

            	
              
                Maternity
      Delivery/Kick Payment

              

            	
              
                Maternity
      Delivery/Kick Payment

              

            	
              
                $                         5,704.89

              

            	
              
                $                            5,458.10

              

            
	
              
                North

              

            	
              
                NICU
      Kick

              

            	
              
                NICU
      Kick

              

            	
              
                $                       82,842.77

              

            	
              
                $                          79,311.86

              

            
	
              
                Southeast

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                0 -
      2 Months, Male and Female

              

            	
              
                $                         1,628.72

              

            	
              
                $                            1,562.20

              

            
	
              
                Southeast

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                3-11
      Months, Male and Female

              

            	
              
                $                            186.14

              

            	
              
                $                               179.04

              

            
	
              
                Southeast

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                1 -
      5 Years, Male and Female

              

            	
              
                $                            133.80

              

            	
              
                $                               128.95

              

            
	
              
                Southeast

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                6-13
      Years, Male and Female

              

            	
              
                $                            121.50

              

            	
              
                $                               117.12

              

            
	
              
                Southeast

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                14-20
      Years, Female

              

            	
              
                $                            195.90

              

            	
              
                $                               188.67

              

            
	
              
                Southeast

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                14-20
      Years, Male

              

            	
              
                $                            132.97

              

            	
              
                $                                128.12

              

            
	
              
                Southeast

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                21
      - 44 Years, Female

              

            	
              
                $                            369.67

              

            	
              
                $                               356.39

              

            
	
              
                Southeast

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                21
      -44 Years, Male

              

            	
              
                $                            396.79

              

            	
              
                $                               382.48

              

            
	
              
                Southeast

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                45+
      Years, Female

              

            	
              
                $                            742.13

              

            	
              
                $                               715.77

              

            
	
              
                Southeast

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                45+
      Years, Male

              

            	
              
                $                            923.92

              

            	
              
                $                               890.72

              

            
	
              
                Southeast

              

            	
              
                PeachCare

              

            	
              
                0 -
      2 Months, Male and Female

              

            	
              
                $                            161.35

              

            	
              
                $                              155.23

              

            
	
              
                Southeast

              

            	
              
                PeachCare

              

            	
              
                3-11
      Months, Male and Female

              

            	
              
                $                           161.35

              

            	
              
                $                               155.23

              

            
	
              
                Southeast

              

            	
              
                PeachCare

              

            	
              
                1 -
      5 Years, Male and Female

              

            	
              
                $                           134.89

              

            	
              
                $                                130.00

              

            
	
              
                Southeast

              

            	
              
                PeachCare

              

            	
              
                6-13
      Years, Male and Female

              

            	
              
                $                           142.79

              

            	
              
                $                                137.75

              

            
	
              
                Southeast

              

            	
              
                PeachCare

              

            	
              
                14-20
      Years, Female

              

            	
              
                $                            162.72

              

            	
              
                $                                156.84

              

            
	
              
                Southeast

              

            	
              
                PeachCare

              

            	
              
                14-20
      Years, Male

              

            	
              
                $                           154.72

              

            	
              
                $                                149.19

              

            
	
              
                Southeast

              

            	
              
                Breast
      and Cervical Cancer

              

            	
              
                Breast
      and Cervical Cancer

              

            	
              
                $                        1,015.86

              

            	
              
                $                               979.58

              

            
	
              
                Southeast

              

            	
              
                Maternity
      Delivery/Kick Payment

              

            	
              
                Maternity
      Delivery/Kick Payment

              

            	
              
                $                         6,031.48

              

            	
              
                $                            5,770.55

              

            
	
              
                Southeast

              

            	
              
                NICU
      Kick

              

            	
              
                NICU
      Kick

              

            	
              
                $                       76,845.57

              

            	
              
                $                          73,576.46

              

            
	
              
                Southwest

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                0 -
      2 Months, Male and Female

              

            	
              
                $                         1,833.77

              

            	
              
                $                            1,757.58

              

            
	
              
                Southwest

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                3-11
      Months, Male and Female

              

            	
              
                $                            205.02

              

            	
              
                $                                197.45

              

            
	
              
                Southwest

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                1 -
      5 Years, Male and Female

              

            	
              
                $                            142.69

              

            	
              
                $                                137.55

              

            
	
              
                Southwest

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                6-13
      Years, Male and Female

              

            	
              
                $                            122.44

              

            	
              
                $                                117.99

              

            
	
              
                Southwest

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                14
      - 20 Years, Female

              

            	
              
                $                            196.04

              

            	
              
                $                                188.92

              

            
	
              
                Southwest

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                14-20
      Years, Male

              

            	
              
                $                           121.47

              

            	
              
                $                                117.05

              

            
	
              
                Southwest

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                21
      - 44 Years, Female

              

            	
              
                $                            331.39

              

            	
              
                $                               319.87

              

            
	
              
                Southwest

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                21
      -44 Years, Male

              

            	
              
                $                            282.47

              

            	
              
                $                               272.58

              

            
	
              
                Southwest

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                45+
      Years, Female

              

            	
              
                $                            577.38

              

            	
              
                $                               557.45

              

            
	
              
                Southwest

              

            	
              
                Medicaid
      (LIM/Refugee/RSM)

              

            	
              
                45+
      Years, Male

              

            	
              
                $                            699.06

              

            	
              
                $                               674.63

              

            
	
              
                Southwest

              

            	
              
                PeachCare

              

            	
              
                0 -
      2 Months, Male and Female

              

            	
              
                $                            178.04

              

            	
              
                $                                171.49

              

            
	
              
                Southwest

              

            	
              
                PeachCare

              

            	
              
                3-11
      Months, Male and Female

              

            	
              
                $                            178.04

              

            	
              
                $                              171.49

              

            
	
              
                Southwest

              

            	
              
                PeachCare

              

            	
              
                1 -
      5 Years, Male and Female

              

            	
              
                $                            150.00

              

            	
              
                $                              144.69

              

            
	
              
                Southwest

              

            	
              
                PeachCare

              

            	
              
                6 -
      13 Years, Male and Female

              

            	
              
                $                            143.89

              

            	
              
                $                                138.78

              

            
	
              
                Southwest

              

            	
              
                PeachCare

              

            	
              
                14-20
      Years, Female

              

            	
              
                $                            171.84

              

            	
              
                $                                165.60

              

            
	
              
                Southwest

              

            	
              
                PeachCare

              

            	
              
                14-20
      Years, Male

              

            	
              
                $                            143.49

              

            	
              
                $                                138.32

              

            
	
              
                Southwest

              

            	
              
                Breast
      and Cervical Cancer

              

            	
              
                Breast
      and Cervical Cancer

              

            	
              
                $                         1,007.61

              

            	
              
                $                               971.63

              

            
	
              
                Southwest

              

            	
              
                Maternity
      Delivery/Kick Payment

              

            	
              
                Maternity
      Delivery/Kick Payment

              

            	
              
                $                         5,536.79

              

            	
              
                $                            5,297.26

              

            
	
              
                Southwest

              

            	
              
                NICU
      Kick

              

            	
              
                NICU
      Kick

              

            	
              
                $                       82,732.78

              

            	
              
                $                          79,204.54

              

            


    

    
      


       

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