Amendment to Medicaid Managed Care Model



 Exhibit 10.3 
  
 MEDICAID MANAGED CARE MODEL CONTRACT AMENDMENT ATTESTATION 
  
 I Todd S. Farha, being an individual authorized to execute agreements 
 on behalf of WellCare of New York Inc. (hereafter “MCO”), hereby attest that the 
                     (Name of Managed Care Organisation) 
 contract amendment submitted by MCO to Rockland County, follows the latest 
                                        
                             (County Name) 
 model contract amendment provided to us by the above named county. This executed amendment contains no deviations from the aforementioned model amendment language. 
  

					
	12/28/04	 	 	 	/s/ Todd S. Farha
	(Date)	 	 	 	(Signature)
			
	 


	 	 	 	Todd S. Farha
	 	 	 	(Print Name In Full)
	 	 	 	President & Chief Executive Officer
	 	 	 	(Title)
			
	/s/ Kathleen R. Casey	 	 	 	 
	(Notary Seal and Signature)	 	 	 	 

  
 I Diane Cole, attest that the County
has reviewed this executed contract amendment and that it follows the latest model contract amendment provided to us by the New York State Department of Health. 
  


					
	1/7/05	 	 	 	/s/ Diane Cole
	(Date)	 	 	 	(Signature)
			
	 	 	 	 	Diane Cole
	 	 	 	 	(Print Name in Full)
			
	 	 	 	 	Managed Care Coordinator
	 	 	 	 	(Title)

  

	
	
	/s/ Debbie P. Gordon
	(Notary Seal and Signature)

  
 Debbie P. Gordon

 Notary Public, State of New York 
 No.01G06006260 
 Qualified in Rockland County 
 Commission Expires April 20, 2006 
  









 MEDICAID MANAGED CARE MODEL CONTRACT 
  
 Amendment of Agreement 
 Between 
  
 Rockland County 
  
 And 
  
 WellCare of New York, Inc. 
  
 This Amendment, effective January 1, 2005, amends the Medicaid Managed Care Model Contract (hereinafter referred to as the “Agreement”) made by and between the
County of Rockland (hereinafter referred to as “LDSS”) and WellCare of New York. Inc. (hereinafter referred to as “MCO” or “Contractor”). 
  
 WHEREAS, the parties entered into an Agreement effective October 1, 2004 for the purpose of providing prepaid case managed health
services to Medical Assistance recipients residing in Rockland County; and 
  
 WHEREAS, the parties desire to amend said Agreement to modify certain provisions to reflect current circumstances and intentions; 
  
 NOW THEREFORE, effective January 1, 2005, it is mutually agreed by the parties to amend this Agreement as follows: 
  
 The attached “Table of Contents for Model Contract” is substituted for the
period beginning January 1, 2005. 
  
 Add to Section 1, Definitions, a
definition for “Permanent Placement Status,” to read as follows: 
  
 “Permanent Placement Status” means the status of an individual in a Residential Health Care Facility [RHCF] when the LDSS determines that the individual is not expected to return home based on medical evidence affirming the
individual’s need for permanent RHCF placement 
  
 Amend Section 3.1 (c),
“Capitation Payments,” to read as follows: 
  

	c)	The monthly capitation payments and the Supplemental Newborn Capitation Payment and the Supplemental Maternity Capitation Payment to the Contractor shall constitute full and
complete payments to the Contractor for all services that the Contractor provides pursuant to this Agreement subject to stop-loss provisions set forth in Section 3.11, 3.12, and 3.13 of this Agreement. 

  

 January 1, 2005 Amendment 
 1 








 This Amendment is effective January 1, 2005, and the Agreement, including the modifications made by this Amendment, shall
remain in effect until September 30, 2005 or until the execution of an extension, renewal or successor agreement as provided for in the Agreement 
  
 In Witness Whereof, the parties have duly executed this Amendment to the Agreement on the dates appearing below their respective signatures below. 
  

									
	For the Contractor:	 	 	 	 For the LDSS:

					
	By	 	 /s/ Todd S. Farha
	 	 	 	By	 	 /s/ Joseph R. Holland

					
	 	 	 Todd S. Farha
	 	 	 	 	 	 Joseph R. Holland

	 	 	 (Printed Name)
	 	 	 	 	 	 (Printed Name)

					
	 Title
	 	 President & Chief Executive Officer
	 	 	 	 Title
	 	 Commissioner

					
	 Date
	 	 12/28/04
	 	 	 	 Date
	 	 1/3/05


  

 January 1, 2005 Amendment 
 2