exv10w27w2w1



 





Exhibit 10.27.2.1




AHCA CONTRACT NO. FAR005

AMENDMENT NO. 3



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





	1.	 	Effective September 1, 2007, Standard Contract, Section II., Item A., Contract Amount, the
first sentence, is hereby revised to change the total amount of the Contract from
***REDACTED*** to ***REDACTED*** (an increase of ***REDACTED***).
	 
	2.	 	Effective September 1, 2007, Attachment I, Scope of Services, Section C., Method of Payment,
Item 1., General, the first paragraph is hereby revised to now read as follows:
	 
	 	 	Notwithstanding the payment amounts which may be computed with the rate tables specified in
Tables 2 thru 8, the sum of total capitation payments under this Contract shall not exceed
the total Contract amount of ***REDACTED*** (an increase of $***REDACTED***).
	 
	3.	 	Effective September 1, 2007, Attachment I, Scope of Services, Exhibits 1-A, 3-A, 4-A, 5-A,
6-A, 7-A, 8-A and 9-A, are hereby included and made a part of the Contract. All references in
the Contract to Exhibits 1, 3, 4, 5, 6, 7, 8 and 9, shall hereinafter refer respectively to
Exhibits 1-A, 3-A, 4-A, 5-A, 6-A, 7-A, 8-A and 9-A.
	 
	4.	 	Effective September 1, 2007, Attachment II, Medicaid Reform Health Plan Model Contract,
Section XIII, Method of Payment, Section B, Capitation Rate Payments, is hereby revised as
follows:






	 	—	 	Sub-item 1.b.(1)(b), is hereby amended to include the following:
	 
	 	 	 	Contract Year 2007-2008 Medicaid Reform rates under current
Capitation Rate
methodology.
	 
	 	—	 	Sub-item 1.b.(1)(i), the first paragraph is hereby amended to now read as follows:
	 
	 	 	 	(i)50% of Risk Adjusted Methodology: The capitation amount based on the
percentage of Risk-Adjusted methodology (h) multiplied by the
Base Rates
column for Risk-Adjusted methodology after budget neutrality factor (g).
	 
	 	—	 	Sub- item 1.b.(1)(j), the first sentence is hereby amended to now read as follows:
	 
	 	 	 	(j)Final Rate (with Enhanced Benefit Adjustment): The current methodology
capitation amount (d) added to the 50% of Risk-Adjusted methodology amount (i).






	5.	 	This Amendment shall be effective upon execution by both
parties or July 1, 2007, whichever is later.






	 	 	 	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 twelve (12) page Amendment
(including all attachments) to be executed by their officials thereunto duly authorized.





	 	 	 	 	 	 	 	 	 	 	 
	AMERIGROUP FLORIDA, INC. D/B/A	 	 	 	STATE OF FLORIDA, AGENCY FOR	 	 
	AMERIGOUP COMMUNITY CARE	 	 	 	HEALTH CARE ADMINISTRATION	 	 
	 
	 	 	 	 	 	 	 	 	 	 
	SIGNED

	 	 	 	 	 	SIGNED	 	 	 	 
	BY:

	 	 	 	 	 	BY:	 	 	 	 
	 

	 	 

	 	 
	 	 	 	 

	 	 
	NAME:

	 	 	 	 	 	NAME:	 	 	 	 
	 

	 	 
	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 
	TITLE:

	 	 	 	 	 	TITLE:	 	 	 	 
	 

	 	 
	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 
	DATE:

	 	 	 	 	 	DATE:	 	 	 	 
	 

	 	 
	 	 	 	 	 	 	 	 





List of Attachments/Exhibits included as part of this Amendment:




	 	 	 	 	 	 	 
	Specify Letter/	 	 	 	 	 	 
	Type	 	Number	 	 	 	Description
	 
	 	 	 	 	 	 
	Exhibit

	 	1-A
	 	 
	 	Benefit Grid Effective September 1, 2007 (2 Pages)*** REDACTED ***

	 
	 	 	 	 	 	 
	Exhibit

	 	3-A
	 	 	 	Comprehensive Component and
Catastrophic Component Capitation Rates (2 Pages) *** REDACTED ***
	 
	 	 	 	 	 	 
	Exhibit

	 	4-A
	 	 	 	Comprehensive Component Only (1 Page) *** REDACTED ***
	 
	 	 	 	 	 	 
	Exhibit

	 	5-A
	 	 	 	Capitation Rates SSI Medicare Part B Only and SSI
Medicare Parts A and B Enrollees for All Medicaid Reform
Counties (1 Page) *** REDACTED ***
	 
	 	 	 	 	 	 
	Exhibit

	 	6-A
	 	 	 	Capitation Rates for HIV/AIDS
Populations for Each Medicaid Reform County (1 Page) *** REDACTED ***
	 
	 	 	 	 	 	 
	Exhibit

	 	7-A
	 	 	 	Capitation Rates for Children with
Chronic Conditions for All Medicaid Reform Counties (1 Page) *** REDACTED ***
	 
	 	 	 	 	 	 
	Exhibit

	 	8-A
	 	 	 	Kick Payment Amounts for Covered
Transplant Services (1 Page) *** REDACTED ***
	 
	 	 	 	 	 	 
	Exhibit

	 	9-A
	 	 	 	Kick Payment Amounts for Covered
Obstetrical Delivery Services (1 Page) *** REDACTED ***