Exhibit 10.20.6
 Contractual Document (CD)
    
    (LOGO)
 Responsible Office: HHSC Office of General Counsel (OGC)
    
    HHSC Contract No. 529-06-0280-00002R
 Subject: HHSC Managed Care Contract
 Part 1: Parties to the Contract:
 Amerigroup Texas, Inc. 2505 N. Highway 360, Suite 300, Grand
Prairie, Texas 75050.
   Part 2: Effective Date of
    
    Part 3: Contract ExpirationAmendment:
    
    Date
    
    Part 4: Operational Start Date:December 1, 2010
    
    August 31, 2013
    
    STAR and CHIP HMOs: September 1, 2006STAR+PLUS HMOs: February 1, 2007CHIP Perinatal HMOs: January 1, 2007
 Part 5: Project Managers:
 HHSC:
    
    HMO:Scott Schalchlin
    
    Aileen McCormickDirector, Health Plan Operations
    
    Amerigroup Texas, Inc.11209 Metric Boulevard, Building H
    
    3800 Buffalo Speedway, Suite 400Austin, Texas 78758
    
    Houston, Texas 77098Phone: 512-491-1866
    
    Phone: 713-218-5101Fax: 512-491-1969
    
    Fax: 713-218-8692E-mail: amccorm@amerigroupcorp.com
 Part 6: Deliver Legal Notices to:
 HHSC:
    
    HMO:General Counsel
    
    Amerigroup Texas, Inc.4900 North Lamar Boulevard, 4th
Floor
    
    3800 Buffalo Speedway, Suite 400Austin, Texas 78751
    
    Houston, Texas 77098Fax: 512-424-6586
    
    Fax: 713-218-8692
 Part 7: HMO Programs and Service Areas:
 (check all that apply).
 Page 1 of 10




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Contractual Document (CD)
    
    (LOGO)
 Responsible Office: HHSC Office of General Counsel (OGC)
    
    HHSC Contract No. 529-06-0280-00002R
 Subject: HHSC Managed Care Contract
 þ Medicaid STAR HMO Program
 Service Areas:
    
    o Bexar
    
    o Lubbockþ Dallas
    
    þ Nueceso El Paso
    
    þ Tarrantþ Harris
    
    þ Travis
  þ Medicaid STAR+PLUS HMO Program
 Service Areas:
    
    þ Bexar
    
    o Nuecesþ Harris
    
    þ Travis
  þ CHIP HMO Program
 Core Service Areas:
    
    o Bexar
    
    þ Nuecesþ Dallas
    
    þ Tarranto El Paso
    
    o Travisþ Harriso LubbockOptional Service Areas:
    
    o Bexar
    
    o Lubbocko El Paso
    
    o Nueceso Harris
    
    o Travis
  þ CHIP Perinatal Program
 Core Service Areas:
    
    o Bexar
    
    o Nueceso Dallas
    
    þ Tarranto El Paso
    
    o Traviso Harriso Lubbock
 Page 2 of 10




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Contractual Document (CD)
    
    (LOGO)
 Responsible Office: HHSC Office of General Counsel (OGC)
    
    HHSC Contract No. 529-06-0280-00002R
 Subject: HHSC Managed Care Contract
 Optional Service Areas:
    
    o Bexar
    
    o Lubbocko El Paso
    
    o Nueceso Harris
    
    o Travis
  Part 8: Payment
  þ Medicaid STAR HMO PROGRAM
 Capitation:
 Service Area: DALLAS
 Rate Period 5
    
    Rate Period 5Rate Cell
    
    9/1/10-11/30/10
    
    12/1/10-8/31/101
    TANF Child > 12 months
    
    $
    127.00
    
    
    $
    127.202
    TANF child < 12 months
    
    $
    412.12
    
    
    $
    417.343
    TANF Adult
    
    $
    312.44
    
    
    $
    307.234
    Pregnant Woman
    
    $
    551.81
    
    
    $
    540.795
    Newborn < 12 months
    
    $
    581.95
    
    
    $
    580.656
    Expansion
Child > 12 months
    
    $
    148.81
    
    
    $
    149.317
    Expansion child < 12 months
    
    $
    265.57
    
    
    $
    267.778
    Federal Mandate child
    
    $
    105.44
    
    
    $
    105.549
    Delivery Supplemental Payment
    
    $
    3,537.13
    
    
    $
    3,537.1310.
    Bariatric Supplemental Payment
    
    $
    23,000.00
    
    
    $
    23,000.00
 Page 3 of 10




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Contractual Document (CD)
    
    (LOGO)
 Responsible Office: HHSC Office of General Counsel (OGC)
    
    HHSC Contract No. 529-06-0280-00002R
 Subject: HHSC Managed Care Contract
 Service Area: HARRIS
 Rate Period 5
    
    Rate Period 5Rate Cell
    
    9/1/10-11/30/10
    
    12/1/10-8/31/101
    
    TANF Child > 12 months
    
    $
    130.00
    
    
    $
    128.572
    
    TANF child < 12 months
    
    $
    371.17
    
    
    $
    369.783
    
    TANF Adult
    
    $
    508.17
    
    
    $
    481.844
    
    Pregnant Woman
    
    $
    605.75
    
    
    $
    565.495
    
    Newborn < 1 2 months
    
    $
    670.32
    
    
    $
    681.166
    
    Expansion Child > 12 months
    
    $
    125.14
    
    
    $
    124.597
    
    Expansion child < 12 months
    
    $
    290.90
    
    
    $
    289.078
    
    Federal Mandate child
    
    $
    98.76
    
    
    $
    98.039
    
    Delivery Supplemental Payment
    
    $
    3,519.20
    
    
    $
    3,519.2010.
    
    Bariatric Supplemental Payment
    
    $
    23,000.00
    
    
    $
    23,000.00
 Service Area: NUECESRate Period 5
    
    Rate Period 5Rate Cell
    
    9/1/10-11/30/10
    
    12/1/10-8/31/101
    
    TANF Child > 12 months
    
    $
    159.39
    
    
    $
    160.822
    
    TANF child < 12 months
    
    $
    460.06
    
    
    $
    471.713
    
    TANF Adult
    
    $
    392.84
    
    
    $
    396.174
    
    Pregnant Woman
    
    $
    570.50
    
    
    $
    601.665
    
    Newborn < 12 months
    
    $
    834.51
    
    
    $
    857.246
    
    Expansion Child > 12 months
    
    $
    172.14
    
    
    $
    173.837
    
    Expansion child < 12 months
    
    $
    415.97
    
    
    $
    422.718
    
    Federal Mandate child
    
    $
    124.49
    
    
    $
    125.169
    
    Delivery Supplemental Payment
    
    $
    3,203.82
    
    
    $
    3,203.8210.
    
    Bariatric Supplemental Payment
    
    $
    23,000.00
    
    
    $
    23,000.00
 Page 4 of 10




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Contractual Document (CD)
    
    (LOGO)
 Responsible Office: HHSC Office of General Counsel (OGC)
    
    HHSC Contract No. 529-06-0280-00002R
 Subject: HHSC Managed Care Contract
 Service Area: TARRANT
 Rate Period 5
    
    Rate Period 5Rate Cell
    
    9/1/10-11/30/10
    
    12/1/10-8/31/101
    TANF Child > 12 months
    
    $
    131.00
    
    
    $
    129.962
    TANF child < 12 months
    
    $
    266.98
    
    
    $
    268.873
    TANF Adult
    
    $
    313.54
    
    
    $
    303.424
    Pregnant Woman
    
    $
    530.17
    
    
    $
    482.715
    Newborn < 12 months
    
    $
    633.85
    
    
    $
    612.336
    Expansion
Child > 12 months
    
    $
    134.77
    
    
    $
    134.747
    Expansion child < 12 months
    
    $
    247.30
    
    
    $
    247.338
    Federal Mandate child
    
    $
    100.70
    
    
    $
    100.389
    Delivery Supplemental Payment
    
    $
    3,635.64
    
    
    $
    3,635.6410.
    Bariatric Supplemental Payment
    
    $
    23,000.00
    
    
    $
    23,000.00
 Service Area: TRAVIS
 Rate Period 5
    
    Rate Period 5Rate Cell
    
    9/1/10-11/30/10
    
    12/1/10-8/31/101
    TANF Child > 12 months
    
    $
    115.31
    
    
    $
    114.512
    TANF child < 12 months
    
    $
    224.84
    
    
    $
    219.173
    TANF Adult
    
    $
    301.35
    
    
    $
    281.054
    Pregnant Woman
    
    $
    577.45
    
    
    $
    510.635
    Newborn < 12 months
    
    $
    707.57
    
    
    $
    691.196
    Expansion Child > 12 months
    
    $
    118.36
    
    
    $
    118.367
    Expansion child < 12 months
    
    $
    337.34
    
    
    $
    337.648
    Federal Mandate child
    
    $
    92.99
    
    
    $
    92.809
    Delivery Supplemental Payment
    
    $
    3,247.49
    
    
    $
    3,247.4910.
    Bariatric Supplemental Payment
    
    $
    23,000.00
    
    
    $
    23,000.00
 STAR SSI Administrative Fee:
 Delivery Supplemental Payment:
 Bariatric Supplemental Payment:
 Page 5 of 10




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Contractual Document (CD)
    
    (LOGO)
 Responsible Office: HHSC Office of General Counsel (OGC)
    
    HHSC Contract No. 529-06-0280-00002R
 Subject: HHSC Managed Care Contract
 þ Medicaid STAR+PLUS HMO Program
 Capitation:
 STAR+PLUS Service Area: BEXARRate Period 5Rate Cell
    
    Capitation Rates1.
    
    Medicaid Only Standard Rate
    
    $
    530.202.
    
    Medicaid Only 1915(C) Nursing Facility Waiver Rate
    
    $
    2,967.953.
    
    Dual Eligible Standard Rate
    
    $
    270.124.
    
    Dual Eligible 1915(C) Nursing Facility Waiver Rate
    
    $
    1,672.835.
    
    Nursing Facility  Medicaid Only
    
    $
    530.206.
    
    Nursing Facility  Dual Eligible
    
    $
    270.127.
    
    Bariatric Supplemental Payment
    
    $
    23,000.00
 STAR+PLUS Service Area: HARRIS (Harris Co. & Harris Contiguous)Rate Period 5Rate Cell
    
    Capitation Rates1.
    
    Medicaid Only Standard Rate
    
    $
    633.412.
    
    Medicaid Only 1915(C) Nursing Facility Waiver Rate
    
    $
    3,382.713.
    
    Dual Eligible Standard Rate
    
    $
    227.944.
    
    Dual Eligible 1915(C) Nursing Facility Waiver Rate
    
    $
    1,488.085.
    
    Nursing Facility  Medicaid Only
    
    $
    633.416.
    
    Nursing Facility  Dual Eligible
    
    $
    227.947.
    
    Bariatric Supplemental Payment
    
    $
    23,000.00
 Page 6 of 10




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Contractual Document (CD)
    
    (LOGO)
 Responsible Office: HHSC Office of General Counsel (OGC)
    
    HHSC Contract No. 529-06-0280-00002R
 Subject: HHSC Managed Care Contract
 START+PLUS Service Area: TRAVISRate Period 5Rate Cell
    
    Capitation Rates1.
    
    Medicaid Only Standard Rate
    
    $
    631.232.
    
    Medicaid Only 1915(C) Nursing Facility Waiver Rate
    
    $
    3,825.773.
    
    Dual Eligible Standard Rate
    
    $
    175.394.
    
    Dual Eligible 1915(C) Nursing Facility Waiver Rate
    
    $
    1,803.905.
    
    Nursing Facility  Medicaid Only
    
    $
    631.236.
    
    Nursing Facility  Dual Eligible
    
    $
    175.397.
    
    Bariatric Supplemental Payment
    
    $
    23,000.00
 Bariatric Supplemental Payment:
 þ CHIP HMO PROGRAM
 Capitation:
 Service Area: DALLASRate Period 5Rate Cell
    
    Capitation Rates1
    
    < Age 1
    
    $
    130.732
    
    Ages 1 through 5
    
    $
    97.673
    
    Ages 6 through 14
    
    $
    77.664
    
    Ages 15 through 18
    
    $
    114.22
 Page 7 of 10




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##### 



Contractual Document (CD)
    
    (LOGO)
 Responsible Office: HHSC Office of General Counsel (OGC)
    
    HHSC Contract No. 529-06-0280-00002R
 Subject: HHSC Managed Care Contract
 Service Area: HARRISRate Period 5Rate Cell
    
    Capitation Rates1
    
    < Age 1
    
    $
    160.662
    
    Ages 1 through 5
    
    $
    96.693
    
    Ages 6 through 14
    
    $
    71.824
    
    Ages 15 through 18
    
    $
    106.50
 Service Area: NUECESRate Period 5Rate Cell
    
    Capitation Rates1
    
    < Age 1
    
    $
    56.672
    
    Ages 1 through 5
    
    $
    99.333
    
    Ages 6 through 14
    
    $
    66.944
    
    Ages 15 through 18
    
    $
    109.97
 Service Area: TARRANTRate Period 5Rate Cell
    
    Capitation Rates1
    
    < Age 1
    
    $
    203.572
    
    Ages 1 through 5
    
    $
    85.803
    
    Ages 6 through 14
    
    $
    65.444
    
    Ages 15 through 18
    
    $
    98.55
 Delivery Supplemental Payment:
 Page 8 of 10




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Contractual Document (CD)
    
    (LOGO)
 Responsible Office: HHSC Office of General Counsel (OGC)
    
    HHSC Contract No. 529-06-0280-00002R
 Subject: HHSC Managed Care Contract
 þ CHIP Perinatal Program
 Capitation:
 Service Area: TARRANTRate Period 5Rate Cell
    
    Capitation Rates1
    
    Perinate Newborn 0% to 185%
    
    $
    276.502
    
    Perinate Newborn Above 185% to 200%
    
    $
    508.973
    
    Perinate 0% to 185%
    
    $
    433.324
    
    Perinate Above 185% to 200%
    
    $
    345.91
 Delivery Supplemental Payment:
 Part 9: Contract Attachments:
  Version 1.16 is replaced with Version
1.17
 Version 1.16 is replaced with Version 1.17 for all
attachments, except if noted.
             Page 9 of 10




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Contractual Document (CD)
    
    (LOGO)
 Responsible Office: HHSC Office of General Counsel (OGC)
    
    HHSC Contract No. 529-06-0280-00002R
 Subject: HHSC Managed Care Contract
   C: HMOs Proposal and Related Documents
 
 Part 10: Special Provision for Nueces Service Area
 Attachment A, Section 10.04 is amended to include sub-part (b) as follows:
 (b)
In addition to the reasons set forth in Section 10.04(a), the Parties expressly understand
and agree that HHSC may, at any time, unilaterally adjust the Rate Period 2 STAR Program Capitation
Rates for the Nueces Service Area. HHSC is entitled to unilaterally adjust such rates,
prospectively and/or retrospectively, if it determines that: (1) the cumulative Rate Period 2
Encounter Data for all HMOs in the Nueces Service Area does not support the Capitation Rates; or
(2) economic factors in the Nueces Service Area significantly and measurably impact providers or
the delivery of Covered Services to Members. For adjustments made pursuant to this Section
10.04(b), HHSC will provide written notice at least ten (10) Business Days before: (1) the
effective date of a prospective adjustment; (2) offsetting Capitation Payments to recover
retrospective adjustments. Any adjustments to the Rate Period 2 Capitation Rates must meet the
actuarial soundness requirements of Attachment A, Section 10.03, Certification of Capitation
Rates.
 Part 11: Signatures:
  Texas Health and Human Services Commission
    
    Amerigroup Texas, Inc./s/ Charles E. Bell, M.D.
Charles
E. Bell, M.D.
    
    /s/  Aileen McCormick
By:
Aileen McCormickDeputy Executive Commissioner for Health Services
    
    Title: President and CEODate: 11/5/10
    
    Date: October 13, 2010
 Page 10 of 10