exhibit10-1.htm


    
      

    

    Back
      to Form 8-K

    Exhibit
      10.1

     

    Medicaid
      HMO
      Contract

    HealthEase
      of Florida,
      Inc. 

     

    
 

    AHCA
      CONTRACT NO. FA619

    AMENDMENT
      NO. 2

    


    THIS
      CONTRACT, entered into
      between the STATE OF FLORIDA,
      AGENCY FOR HEALTH CARE ADMINISTRATION, hereinafter referred to as the
      "Agency" and HEALTHEASE OF
      FLORIDA, INC., hereinafter referred to as the "Vendor" or “Health Plan”,
      is hereby amended as follows:

    


    
      	
              1.

            	
              Effective
                September 1, 2007, Attachment I, Scope of Services, is hereby amended
                to
                include Exhibit III-B, September 1, 2007- August 31, 2008 Medicaid
                Non-Reform HMO Capitation Rates, attached hereto and made a part
                of the
                Contract. All references in the Contract to Exhibit III-A, September
                1,
                2007 – August 31, 2008 Medicaid Non-Reform HMO Capitation Rates, shall
                hereinafter instead refer to Exhibit III-B, September 1, 2007- August
                31,
                2008 Medicaid Non-Reform HMO Capitation Rates, as appropriate.
                

            


    

    


    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 are hereby made a 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 six (6) page Amendment (which includes all attachments hereto)
      to be executed by their officials thereunto duly authorized.

    


    


    
      	
              HEALTHEASE
                OF FLORIDA, INC.

            	
              STATE
                OF FLORIDA, AGENCY FOR
                HEALTH CARE ADMINISTRATION

            
	
              SIGNED
                BY:   /s/  Todd
                S. Farha

            	
              SIGNED
                BY:   /s/  Andrew
                C. Agwunobi

            
	
              NAME: 
                Todd S.
                Farha

            	
              NAME: Andrew
                C. Agwunobi,
                M.D.

            
	
              TITLE: 
                President
                and
                CEO

            	
              TITLE: 
                Secretary

            
	
              DATE:  12/7/07                                
                

            	
              DATE:
                12/10/07                      
                

            
	 	 
	 	 
	
              List
                of attachments included as part of this Amendment:

            
	
              Specify
                Type

            	
              Letter/
                Number                                
                

            	
              Description

            
	
              Exhibit

            	
              III-B

            	
              September
                1, 2007- August 31, 2008 Medicaid Non-Reform HMO Capitation Rates
                (5
                Pages)

            


    

    


    


    


    


    REMAINDER
      OF PAGE INTENTIONALLY LEFT BLANK

    


    
      
        
          
            AHCA
              Contract No. FA619, Amendment No. 2, Page 1 of 1

            


          

          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

    

     

    
      
        	
                ATTACHMENT
                  III-B

              
	
                September
                  1, 2007- August 31,
                  2008

              
	
                MEDICAID
                  Non-Reform HMO CAPITATION
                  RATES

              
	
                By
                  Area , Age and Eligibility
                  Category

                Estimated
                  Health Plan Rates (Not for use unless approved by
                  CMS)

              


      

    

    
      
        	
                TABLE
                  1

              	 	 	 	 	 	 	 	 
	
                General
                  Rates:

              	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 TANF	 	 SSI-N 	
                 

              	
                SSI-B

              	 	
                SSI-AB

              
	
                Area

              	
                BTHMO

                +2MO

              	
                3MO-11MO

              	
                AGE


                (1-5)

              	
                AGE


                (6-13)

              	
                AGE


                (14-20)

              	
                AGE


                (21-54)

              	
                AGE


                (55+)

              	 	
                BTHMO

                +2MO

              	
                3MO-11MO

              	
                AGE


                (1-5)

              	
                AGE

                 (6-13)

              	
                AGE


                (14-20)

              	
                AGE


                (21-54)

              	
                AGE


                (55+)

              	 	 	 	
                AGE


                (65-)

              	
                AGE


                (65+)

              
	 	 	 	 	 	
                Female

              	
                Male

              	
                Female

              	
                Male

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                01

              	
                1,131.99

              	
                202.30

              	
                105.58

              	
                66.22

              	
                135.19

              	
                72.29

              	
                265.45

              	
                167.89

              	
                347.47

              	 	
                10,081.87

              	
                1,458.88

              	
                435.95

              	
                201.26

              	
                222.08

              	
                716.10

              	
                703.88

              	 	
                270.84

              	 	
                98.28

              	
                80.72

              
	
                02

              	
                1,131.99

              	
                202.30

              	
                105.58

              	
                66.22

              	
                135.19

              	
                72.29

              	
                265.45

              	
                167.89

              	
                347.47

              	 	
                10,081.87

              	
                1,458.88

              	
                435.95

              	
                201.26

              	
                222.08

              	
                716.10

              	
                703.88

              	 	
                270.84

              	 	
                98.28

              	
                80.72

              
	
                03

              	
                1,296.42

              	
                233.58

              	
                122.13

              	
                77.48

              	
                156.47

              	
                84.50

              	
                308.68

              	
                196.24

              	
                408.68

              	 	
                11,326.29

              	
                1,656.79

              	
                495.12

              	
                233.33

              	
                256.55

              	
                826.59

              	
                816.63

              	 	
                272.62

              	 	
                91.40

              	
                75.41

              
	
                04

              	
                1,128.87

              	
                203.75

              	
                106.78

              	
                67.92

              	
                136.68

              	
                74.01

              	
                269.88

              	
                171.79

              	
                358.59

              	 	
                10,675.98

              	
                1,563.58

              	
                467.86

              	
                220.87

              	
                242.36

              	
                781.86

              	
                772.10

              	 	
                329.54

              	 	
                94.19

              	
                77.67

              
	
                05

              	
                1,260.50

              	
                227.66

              	
                119.09

              	
                75.94

              	
                152.59

              	
                82.61

              	
                301.42

              	
                191.81

              	
                400.30

              	 	
                11,774.49

              	
                1,721.01

              	
                514.94

              	
                241.96

              	
                266.53

              	
                857.42

              	
                846.21

              	 	
                228.63

              	 	
                88.38

              	
                73.66

              
	
                06

              	
                1,111.64

              	
                201.87

              	
                106.04

              	
                68.10

              	
                135.60

              	
                74.02

              	
                269.07

              	
                171.81

              	
                360.32

              	 	
                10,832.05

              	
                1,590.31

              	
                475.95

              	
                225.91

              	
                247.84

              	
                799.09

              	
                790.01

              	 	
                283.50

              	 	
                85.45

              	
                70.71

              
	
                07

              	
                1,129.81

              	
                204.44

              	
                107.10

              	
                68.40

              	
                137.11

              	
                74.43

              	
                271.08

              	
                172.77

              	
                361.05

              	 	
                11,163.75

              	
                1,640.70

              	
                490.80

              	
                233.68

              	
                256.10

              	
                824.52

              	
                815.86

              	 	
                326.33

              	 	
                88.91

              	
                73.77

              
	
                08

              	
                1,059.95

              	
                192.36

              	
                100.83

              	
                64.75

              	
                129.15

              	
                70.40

              	
                255.88

              	
                163.25

              	
                342.35

              	 	
                9,491.26

              	
                1,388.78

              	
                415.62

              	
                196.24

              	
                215.38

              	
                694.16

              	
                685.42

              	 	
                190.94

              	 	
                84.41

              	
                69.83

              
	
                09

              	
                1,098.82

              	
                197.96

              	
                103.63

              	
                65.91

              	
                132.56

              	
                71.62

              	
                261.85

              	
                166.57

              	
                346.99

              	 	
                10,597.24

              	
                1,556.56

              	
                465.60

              	
                221.41

              	
                242.54

              	
                781.98

              	
                773.10

              	 	
                204.68

              	 	
                91.80

              	
                76.03

              
	
                10

              	
                1,119.46

              	
                203.01

              	
                106.51

              	
                68.32

              	
                136.20

              	
                74.23

              	
                270.06

              	
                172.18

              	
                360.84

              	 	
                13,743.01

              	
                2,028.53

              	
                606.68

              	
                290.75

              	
                319.15

              	
                1,026.77

              	
                1,016.73

              	 	
                255.52

              	 	
                105.04

              	
                86.99

              
	
                11

              	
                1,448.96

              	
                260.41

              	
                136.24

              	
                86.18

              	
                174.38

              	
                94.02

              	
                343.72

              	
                218.26

              	
                453.77

              	 	
                14,396.52

              	
                2,111.55

              	
                631.62

              	
                299.15

              	
                329.01

              	
                1,058.44

              	
                1,046.51

              	 	
                335.29

              	 	
                159.90

              	
                130.52

              


      

      
        	
                 

                TABLE
                  2

              	 	 	 	 	 	 	 	 	 	 	 
	
                General
                  + Mental Health
                  Rates:

              	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	
                 TANF

              	 	
                 SSI-N

              	 	
                SSI-B

              	 	 SSI-AB
	
                Area

              	
                BTHMO

                +2MO

              	
                3MO-11MO

              	
                AGE


                (1-5)

              	
                AGE


                (6-13)

              	
                AGE


                (14-20)

              	
                AGE

                (21-54)

              	
                AGE


                (55+)

              	 	
                BTHMO

                +2MO

              	
                3MO-11MO

              	
                AGE


                (1-5)

              	
                AGE


                (6-13)

              	
                AGE


                (14-20)

              	
                AGE


                (21-54)

              	
                AGE


                (55+)

              	 	 	 	
                AGE


                (65-)

              	
                AGE


                (65+)

              
	 	 	 	 	 	
                Female

              	
                Male

              	
                Female

              	
                Male

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                01

              	
                1,132.01

              	
                202.32

              	
                107.22

              	
                77.91

              	
                146.11

              	
                83.21

              	
                269.89

              	
                172.33

              	
                351.22

              	 	
                10,081.95

              	
                1,458.96

              	
                443.39

              	
                249.30

              	
                266.06

              	
                797.48

              	
                734.86

              	 	
                271.05

              	 	
                109.93

              	
                92.37

              
	
                02

              	
                1,132.02

              	
                202.33

              	
                108.49

              	
                86.47

              	
                148.60

              	
                85.70

              	
                268.86

              	
                171.30

              	
                350.43

              	 	
                10,082.03

              	
                1,459.04

              	
                449.74

              	
                280.06

              	
                267.29

              	
                768.77

              	
                728.75

              	 	
                291.04

              	 	
                113.28

              	
                95.72

              
	
                03

              	
                1,296.43

              	
                233.59

              	
                123.45

              	
                86.66

              	
                162.55

              	
                90.58

              	
                310.23

              	
                197.79

              	
                410.02

              	 	
                11,326.36

              	
                1,656.86

              	
                501.38

              	
                269.08

              	
                277.06

              	
                850.48

              	
                827.91

              	 	
                279.47

              	 	
                100.38

              	
                84.39

              
	
                04

              	
                1,128.88

              	
                203.76

              	
                108.15

              	
                77.48

              	
                143.01

              	
                80.34

              	
                271.49

              	
                173.40

              	
                359.98

              	 	
                10,676.09

              	
                1,563.69

              	
                477.61

              	
                276.60

              	
                274.33

              	
                819.11

              	
                789.69

              	 	
                354.09

              	 	
                110.96

              	
                94.44

              
	
                05

              	
                1,260.51

              	
                227.67

              	
                120.30

              	
                84.61

              	
                160.70

              	
                90.72

              	
                304.71

              	
                195.10

              	
                403.08

              	 	
                11,774.54

              	
                1,721.06

              	
                519.96

              	
                274.37

              	
                296.20

              	
                912.32

              	
                867.11

              	 	
                231.36

              	 	
                101.19

              	
                86.47

              
	
                06

              	
                1,111.66

              	
                201.89

              	
                107.89

              	
                81.34

              	
                147.98

              	
                86.40

              	
                274.10

              	
                176.84

              	
                364.57

              	 	
                10,832.12

              	
                1,590.38

              	
                482.47

              	
                268.01

              	
                286.38

              	
                870.40

              	
                817.15

              	 	
                284.81

              	 	
                89.33

              	
                74.59

              
	
                07

              	
                1,129.83

              	
                204.46

              	
                108.88

              	
                81.08

              	
                148.96

              	
                86.28

              	
                275.90

              	
                177.59

              	
                365.12

              	 	
                11,163.81

              	
                1,640.76

              	
                496.92

              	
                273.18

              	
                292.26

              	
                891.44

              	
                841.33

              	 	
                328.92

              	 	
                99.42

              	
                84.28

              
	
                08

              	
                1,059.96

              	
                192.37

              	
                102.09

              	
                73.55

              	
                134.98

              	
                76.23

              	
                257.36

              	
                164.73

              	
                343.63

              	 	
                9,491.33

              	
                1,388.85

              	
                421.62

              	
                230.52

              	
                235.05

              	
                717.07

              	
                696.24

              	 	
                197.79

              	 	
                97.63

              	
                83.05

              
	
                09

              	
                1,098.84

              	
                197.98

              	
                105.18

              	
                76.72

              	
                139.72

              	
                78.78

              	
                263.67

              	
                168.39

              	
                348.57

              	 	
                10,597.31

              	
                1,556.63

              	
                471.93

              	
                257.55

              	
                263.28

              	
                806.13

              	
                784.51

              	 	
                211.53

              	 	
                101.39

              	
                85.62

              
	
                10

              	
                1,119.48

              	
                203.03

              	
                108.43

              	
                81.68

              	
                145.05

              	
                83.08

              	
                272.31

              	
                174.43

              	
                362.79

              	 	
                13,743.10

              	
                2,028.62

              	
                615.03

              	
                338.45

              	
                346.52

              	
                1,058.65

              	
                1,031.78

              	 	
                262.37

              	 	
                113.09

              	
                95.04

              
	
                11

              	
                1,448.98

              	
                260.43

              	
                137.86

              	
                97.47

              	
                181.86

              	
                101.50

              	
                345.62

              	
                220.16

              	
                455.42

              	 	
                14,396.60

              	
                2,111.63

              	
                638.59

              	
                338.94

              	
                351.84

              	
                1,085.04

              	
                1,059.07

              	 	
                342.52

              	 	
                167.95

              	
                138.57

              
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 


      

       

      AHCA
        Contract No. FA619,
        Attachment III-B, Page 1 of 5

       

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

        
          	
                  ATTACHMENT
                    III-B

                
	
                  September
                    1, 2007- August 31,
                    2008

                
	
                  MEDICAID
                    Non-Reform HMO CAPITATION
                    RATES

                
	
                  By
                    Area , Age and Eligibility
                    Category

                  Estimated
                    Health Plan Rates (Not for use unless approved by
                    CMS)

                


        

         

      

      
        	
                TABLE
                  3

              	 	 	 	 	 	 	 	 	 	 
	
                General
                  + MH + Dental
                  Rates:

              	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	
                TANF

              	 	 SSI-N	 	
                SSI-B

              	 	
                SSI-AB

              
	
                Area

              	
                BTHMO

                +2MO

              	
                3MO-11MO

              	
                AGE

                 (1-5)

              	
                AGE


                (6-13)

              	
                AGE


                (14-20)

              	
                AGE


                (21-54)

              	
                AGE


                (55+)

              	 	
                BTHMO

                +2MO

              	
                3MO-11MO

              	
                AGE


                (1-5)

              	
                AGE

                 (6-13)

              	
                AGE

                 (14-20)

              	
                AGE


                (21-54)

              	
                AGE


                (55+)

              	 	 	 	
                AGE


                (65-)

              	
                AGE


                (65+)

              
	 	 	 	 	 	
                Female

              	
                Male

              	
                Female

              	
                Male

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                01

              	
                1,132.02

              	
                202.33

              	
                109.31

              	
                82.23

              	
                150.59

              	
                86.99

              	
                271.74

              	
                173.97

              	
                354.63

              	 	
                10,081.95

              	
                1,458.97

              	
                445.59

              	
                253.12

              	
                269.40

              	
                800.35

              	
                738.28

              	 	
                271.55

              	 	
                112.24

              	
                93.85

              
	
                02

              	
                1,132.03

              	
                202.34

              	
                110.58

              	
                90.79

              	
                153.08

              	
                89.48

              	
                270.71

              	
                172.94

              	
                353.84

              	 	
                10,082.03

              	
                1,459.05

              	
                451.94

              	
                283.88

              	
                270.63

              	
                771.64

              	
                732.17

              	 	
                291.54

              	 	
                115.59

              	
                97.20

              
	
                03

              	
                1,296.44

              	
                233.60

              	
                126.52

              	
                93.00

              	
                169.14

              	
                96.13

              	
                313.24

              	
                200.46

              	
                415.57

              	 	
                11,326.37

              	
                1,656.88

              	
                504.76

              	
                274.93

              	
                282.17

              	
                854.04

              	
                832.15

              	 	
                280.01

              	 	
                103.46

              	
                86.37

              
	
                04

              	
                1,128.89

              	
                203.77

              	
                110.20

              	
                81.71

              	
                147.39

              	
                84.03

              	
                274.30

              	
                175.89

              	
                365.17

              	 	
                10,676.09

              	
                1,563.70

              	
                479.82

              	
                280.43

              	
                277.68

              	
                822.42

              	
                793.64

              	 	
                356.10

              	 	
                114.04

              	
                96.42

              
	
                05

              	
                1,260.52

              	
                227.69

              	
                123.77

              	
                91.76

              	
                168.12

              	
                96.98

              	
                311.90

              	
                201.49

              	
                416.36

              	 	
                11,774.55

              	
                1,721.08

              	
                524.88

              	
                282.89

              	
                303.65

              	
                919.87

              	
                876.10

              	 	
                235.79

              	 	
                109.53

              	
                91.82

              
	
                06

              	
                1,111.67

              	
                201.90

              	
                110.53

              	
                86.79

              	
                153.63

              	
                91.17

              	
                277.72

              	
                180.05

              	
                371.26

              	 	
                10,832.13

              	
                1,590.40

              	
                485.64

              	
                273.51

              	
                291.19

              	
                874.82

              	
                822.42

              	 	
                286.65

              	 	
                94.11

              	
                77.66

              
	
                07

              	
                1,129.84

              	
                204.47

              	
                111.04

              	
                85.54

              	
                153.58

              	
                90.17

              	
                278.43

              	
                179.84

              	
                369.79

              	 	
                11,163.81

              	
                1,640.77

              	
                500.03

              	
                278.58

              	
                296.97

              	
                894.55

              	
                845.04

              	 	
                330.54

              	 	
                102.58

              	
                86.31

              
	
                08

              	
                1,059.97

              	
                192.38

              	
                105.11

              	
                79.80

              	
                141.46

              	
                81.69

              	
                260.37

              	
                167.40

              	
                349.19

              	 	
                9,491.34

              	
                1,388.87

              	
                424.74

              	
                235.93

              	
                239.77

              	
                720.67

              	
                700.54

              	 	
                199.27

              	 	
                100.78

              	
                85.06

              
	
                09

              	
                1,098.85

              	
                197.99

              	
                108.10

              	
                82.75

              	
                145.98

              	
                84.06

              	
                265.42

              	
                169.94

              	
                351.80

              	 	
                10,597.31

              	
                1,556.64

              	
                474.66

              	
                262.28

              	
                267.41

              	
                807.81

              	
                786.52

              	 	
                212.26

              	 	
                103.23

              	
                86.80

              
	
                10

              	
                1,119.49

              	
                203.04

              	
                111.29

              	
                87.56

              	
                151.15

              	
                88.23

              	
                274.13

              	
                176.05

              	
                366.16

              	 	
                13,743.11

              	
                2,028.64

              	
                618.77

              	
                344.93

              	
                352.19

              	
                1,060.76

              	
                1,034.30

              	 	
                264.42

              	 	
                115.66

              	
                96.69

              
	
                11

              	
                1,448.99

              	
                260.44

              	
                141.58

              	
                105.13

              	
                189.81

              	
                108.20

              	
                347.23

              	
                221.59

              	
                458.40

              	 	
                14,396.61

              	
                2,111.65

              	
                642.83

              	
                346.28

              	
                358.26

              	
                1,088.67

              	
                1,063.40

              	 	
                346.92

              	 	
                172.01

              	
                141.17

              
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                TABLE
                  4

              	 	 	 	 	 	 	 	 	 
	
                General
                  + MH + Transportation
                  Rates:

              	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	
                 TANF

              	 	
                SSI-N

              	 	
                SSI-B

              	 	
                SSI-AB

              
	
                Area

              	
                BTHMO

                +2MO

              	
                3MO-11MO

              	
                AGE


                (1-5)

              	
                AGE

                 (6-13)

              	
                AGE


                (14-20)

              	
                AGE


                (21-54)

              	
                AGE


                (55+)

              	 	
                BTHMO

                +2MO

              	
                3MO-11MO

              	
                AGE


                (1-5)

              	
                AGE


                (6-13)

              	
                AGE


                (14-20)

              	
                AGE


                (21-54)

              	
                AGE


                (55+)

              	 	 	 	
                AGE


                (65-)

              	
                AGE


                (65+)

              
	 	 	 	 	 	
                Female

              	
                Male

              	
                Female

              	
                Male

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                01

              	
                1,137.56

              	
                203.71

              	
                108.08

              	
                78.43

              	
                148.03

              	
                84.47

              	
                272.98

              	
                174.71

              	
                354.40

              	 	
                10,125.36

              	
                1,486.99

              	
                449.03

              	
                251.78

              	
                272.18

              	
                817.47

              	
                751.37

              	 	
                277.82

              	 	
                123.66

              	
                101.13

              
	
                02

              	
                1,137.57

              	
                203.72

              	
                109.35

              	
                86.99

              	
                150.52

              	
                86.96

              	
                271.95

              	
                173.68

              	
                353.61

              	 	
                10,125.44

              	
                1,487.07

              	
                455.38

              	
                282.54

              	
                273.41

              	
                788.76

              	
                745.26

              	 	
                297.81

              	 	
                127.01

              	
                104.48

              
	
                03

              	
                1,303.13

              	
                235.26

              	
                124.49

              	
                87.29

              	
                164.87

              	
                92.09

              	
                313.95

              	
                200.67

              	
                413.86

              	 	
                11,381.17

              	
                1,692.25

              	
                508.50

              	
                272.20

              	
                284.79

              	
                875.73

              	
                848.76

              	 	
                288.09

              	 	
                120.22

              	
                97.05

              
	
                04

              	
                1,133.91

              	
                205.01

              	
                108.93

              	
                77.95

              	
                144.75

              	
                81.48

              	
                274.28

              	
                175.56

              	
                362.87

              	 	
                10,720.46

              	
                1,592.34

              	
                483.38

              	
                279.13

              	
                280.59

              	
                839.55

              	
                806.56

              	 	
                361.06

              	 	
                126.74

              	
                104.50

              
	
                05

              	
                1,264.71

              	
                228.72

              	
                120.95

              	
                85.01

              	
                162.15

              	
                91.67

              	
                307.04

              	
                196.90

              	
                405.49

              	 	
                11,809.84

              	
                1,743.85

              	
                524.54

              	
                276.38

              	
                301.18

              	
                928.58

              	
                880.53

              	 	
                237.24

              	 	
                115.22

              	
                95.42

              
	
                06

              	
                1,115.71

              	
                202.90

              	
                108.52

              	
                81.72

              	
                149.38

              	
                87.31

              	
                276.35

              	
                178.58

              	
                366.89

              	 	
                10,866.95

              	
                1,612.87

              	
                487.00

              	
                270.00

              	
                291.30

              	
                886.44

              	
                830.40

              	 	
                290.13

              	 	
                100.93

              	
                81.99

              
	
                07

              	
                1,133.77

              	
                205.44

              	
                109.49

              	
                81.45

              	
                150.32

              	
                87.17

              	
                278.09

              	
                179.28

              	
                367.38

              	 	
                11,201.13

              	
                1,664.85

              	
                501.77

              	
                275.30

              	
                297.53

              	
                908.63

              	
                855.51

              	 	
                334.56

              	 	
                111.55

              	
                92.03

              
	
                08

              	
                1,065.54

              	
                193.77

              	
                102.95

              	
                74.07

              	
                136.91

              	
                77.49

              	
                260.46

              	
                167.12

              	
                346.83

              	 	
                9,532.67

              	
                1,415.54

              	
                427.00

              	
                232.88

              	
                240.88

              	
                736.11

              	
                711.96

              	 	
                203.87

              	 	
                112.43

              	
                92.50

              
	
                09

              	
                1,104.22

              	
                199.32

              	
                106.02

              	
                77.23

              	
                141.58

              	
                79.99

              	
                266.66

              	
                170.70

              	
                351.65

              	 	
                10,640.50

              	
                1,584.51

              	
                477.55

              	
                260.02

              	
                269.38

              	
                826.01

              	
                800.93

              	 	
                218.45

              	 	
                117.20

              	
                95.70

              
	
                10

              	
                1,123.27

              	
                203.97

              	
                109.01

              	
                82.04

              	
                146.35

              	
                83.94

              	
                274.42

              	
                176.05

              	
                364.96

              	 	
                13,782.23

              	
                2,053.89

              	
                620.11

              	
                340.69

              	
                352.05

              	
                1,076.67

              	
                1,046.66

              	 	
                269.67

              	 	
                130.75

              	
                106.30

              
	
                11

              	
                1,452.24

              	
                261.24

              	
                138.36

              	
                97.78

              	
                182.98

              	
                102.24

              	
                347.43

              	
                221.56

              	
                457.29

              	 	
                14,425.98

              	
                2,130.60

              	
                642.40

              	
                340.62

              	
                355.99

              	
                1,098.57

              	
                1,070.25

              	 	
                347.44

              	 	
                180.46

              	
                146.55

              
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 


      

       

      AHCA Contract No. FA619, Attachment
        III-B, Page 2 of 5

       

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

        
          	
                  ATTACHMENT
                    III-B

                
	
                  September
                    1, 2007- August 31,
                    2008

                
	
                  MEDICAID
                    Non-Reform HMO CAPITATION
                    RATES

                
	
                  By
                    Area , Age and Eligibility
                    Category

                  Estimated
                    Health Plan Rates (Not for use unless approved by
                    CMS)

                


        

         

      

      
        	
                TABLE
                  5

              	 	 	 	 	 	 	 	 	 
	
                General
                  + Transportation
                  Rates:

              	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	
                TANF

              	 	
                 SSI-N

              	 	
                SSI-B

              	 	
                SSI-AB

              
	
                Area

              	
                BTHMO

                +2MO

              	
                3MO-11MO

              	
                AGE


                (1-5)

              	
                AGE


                (6-13)

              	
                AGE


                (14-20)

              	
                AGE


                (21-54)

              	
                AGE


                (55+)

              	 	
                BTHMO

                +2MO

              	
                3MO-11MO

              	
                AGE


                (1-5)

              	
                AGE


                (6-13)

              	
                AGE


                (14-20)

              	
                AGE


                (21-54)

              	
                AGE


                (55+)

              	 	 	 	
                AGE

                 (65-)

              	
                AGE


                (65+)

              
	 	 	 	 	 	
                Female

              	
                Male

              	
                Female

              	
                Male

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                01

              	
                1,137.54

              	
                203.69

              	
                106.44

              	
                66.74

              	
                137.11

              	
                73.55

              	
                268.54

              	
                170.27

              	
                350.65

              	 	
                10,125.28

              	
                1,486.91

              	
                441.59

              	
                203.74

              	
                228.20

              	
                736.09

              	
                720.39

              	 	
                277.61

              	 	
                112.01

              	
                89.48

              
	
                02

              	
                1,137.54

              	
                203.69

              	
                106.44

              	
                66.74

              	
                137.11

              	
                73.55

              	
                268.54

              	
                170.27

              	
                350.65

              	 	
                10,125.28

              	
                1,486.91

              	
                441.59

              	
                203.74

              	
                228.20

              	
                736.09

              	
                720.39

              	 	
                277.61

              	 	
                112.01

              	
                89.48

              
	
                03

              	
                1,303.12

              	
                235.25

              	
                123.17

              	
                78.11

              	
                158.79

              	
                86.01

              	
                312.40

              	
                199.12

              	
                412.52

              	 	
                11,381.10

              	
                1,692.18

              	
                502.24

              	
                236.45

              	
                264.28

              	
                851.84

              	
                837.48

              	 	
                281.24

              	 	
                111.24

              	
                88.07

              
	
                04

              	
                1,133.90

              	
                205.00

              	
                107.56

              	
                68.39

              	
                138.42

              	
                75.15

              	
                272.67

              	
                173.95

              	
                361.48

              	 	
                10,720.35

              	
                1,592.23

              	
                473.63

              	
                223.40

              	
                248.62

              	
                802.30

              	
                788.97

              	 	
                336.51

              	 	
                109.97

              	
                87.73

              
	
                05

              	
                1,264.70

              	
                228.71

              	
                119.74

              	
                76.34

              	
                154.04

              	
                83.56

              	
                303.75

              	
                193.61

              	
                402.71

              	 	
                11,809.79

              	
                1,743.80

              	
                519.52

              	
                243.97

              	
                271.51

              	
                873.68

              	
                859.63

              	 	
                234.51

              	 	
                102.41

              	
                82.61

              
	
                06

              	
                1,115.69

              	
                202.88

              	
                106.67

              	
                68.48

              	
                137.00

              	
                74.93

              	
                271.32

              	
                173.55

              	
                362.64

              	 	
                10,866.88

              	
                1,612.80

              	
                480.48

              	
                227.90

              	
                252.76

              	
                815.13

              	
                803.26

              	 	
                288.82

              	 	
                97.05

              	
                78.11

              
	
                07

              	
                1,133.75

              	
                205.42

              	
                107.71

              	
                68.77

              	
                138.47

              	
                75.32

              	
                273.27

              	
                174.46

              	
                363.31

              	 	
                11,201.07

              	
                1,664.79

              	
                495.65

              	
                235.80

              	
                261.37

              	
                841.71

              	
                830.04

              	 	
                331.97

              	 	
                101.04

              	
                81.52

              
	
                08

              	
                1,065.53

              	
                193.76

              	
                101.69

              	
                65.27

              	
                131.08

              	
                71.66

              	
                258.98

              	
                165.64

              	
                345.55

              	 	
                9,532.60

              	
                1,415.47

              	
                421.00

              	
                198.60

              	
                221.21

              	
                713.20

              	
                701.14

              	 	
                197.02

              	 	
                99.21

              	
                79.28

              
	
                09

              	
                1,104.20

              	
                199.30

              	
                104.47

              	
                66.42

              	
                134.42

              	
                72.83

              	
                264.84

              	
                168.88

              	
                350.07

              	 	
                10,640.43

              	
                1,584.44

              	
                471.22

              	
                223.88

              	
                248.64

              	
                801.86

              	
                789.52

              	 	
                211.60

              	 	
                107.61

              	
                86.11

              
	
                10

              	
                1,123.25

              	
                203.95

              	
                107.09

              	
                68.68

              	
                137.50

              	
                75.09

              	
                272.17

              	
                173.80

              	
                363.01

              	 	
                13,782.14

              	
                2,053.80

              	
                611.76

              	
                292.99

              	
                324.68

              	
                1,044.79

              	
                1,031.61

              	 	
                262.82

              	 	
                122.70

              	
                98.25

              
	
                11

              	
                1,452.22

              	
                261.22

              	
                136.74

              	
                86.49

              	
                175.50

              	
                94.76

              	
                345.53

              	
                219.66

              	
                455.64

              	 	
                14,425.90

              	
                2,130.52

              	
                635.43

              	
                300.83

              	
                333.16

              	
                1,071.97

              	
                1,057.69

              	 	
                340.21

              	 	
                172.41

              	
                138.50

              
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                TABLE
                  6

              	 	 	 	 	 	 	 	 
	
                General
                  + Dental
                  Rates:

              	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	
                TANF

              	 	
                 SSI-N

              	 	
                SSI-B

              	 	
                SSI-AB

              
	
                Area

              	
                BTHMO

                +2MO

              	
                3MO-11MO

              	
                AGE


                (1-5)

              	
                AGE


                (6-13)

              	
                AGE


                (14-20)

              	
                AGE


                (21-54)

              	
                AGE


                (55+)

              	 	
                BTHMO

                +2MO

              	
                3MO-11MO

              	
                AGE


                (1-5)

              	
                AGE


                (6-13)

              	
                AGE


                (14-20)

              	
                AGE


                (21-54)

              	
                AGE


                (55+)

              	 	 	 	
                AGE


                (65-)

              	
                AGE


                (65+)

              
	 	 	 	 	 	
                Female

              	
                Male

              	
                Female

              	
                Male

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                01

              	
                1,132.00

              	
                202.31

              	
                107.67

              	
                70.54

              	
                139.67

              	
                76.07

              	
                267.30

              	
                169.53

              	
                350.88

              	 	
                10,081.87

              	
                1,458.89

              	
                438.15

              	
                205.08

              	
                225.42

              	
                718.97

              	
                707.30

              	 	
                271.34

              	 	
                100.59

              	
                82.20

              
	
                02

              	
                1,132.00

              	
                202.31

              	
                107.67

              	
                70.54

              	
                139.67

              	
                76.07

              	
                267.30

              	
                169.53

              	
                350.88

              	 	
                10,081.87

              	
                1,458.89

              	
                438.15

              	
                205.08

              	
                225.42

              	
                718.97

              	
                707.30

              	 	
                271.34

              	 	
                100.59

              	
                82.20

              
	
                03

              	
                1,296.43

              	
                233.59

              	
                125.20

              	
                83.82

              	
                163.06

              	
                90.05

              	
                311.69

              	
                198.91

              	
                414.23

              	 	
                11,326.30

              	
                1,656.81

              	
                498.50

              	
                239.18

              	
                261.66

              	
                830.15

              	
                820.87

              	 	
                273.16

              	 	
                94.48

              	
                77.39

              
	
                04

              	
                1,128.88

              	
                203.76

              	
                108.83

              	
                72.15

              	
                141.06

              	
                77.70

              	
                272.69

              	
                174.28

              	
                363.78

              	 	
                10,675.98

              	
                1,563.59

              	
                470.07

              	
                224.70

              	
                245.71

              	
                785.17

              	
                776.05

              	 	
                331.55

              	 	
                97.27

              	
                79.65

              
	
                05

              	
                1,260.51

              	
                227.68

              	
                122.56

              	
                83.09

              	
                160.01

              	
                88.87

              	
                308.61

              	
                198.20

              	
                413.58

              	 	
                11,774.50

              	
                1,721.03

              	
                519.86

              	
                250.48

              	
                273.98

              	
                864.97

              	
                855.20

              	 	
                233.06

              	 	
                96.72

              	
                79.01

              
	
                06

              	
                1,111.65

              	
                201.88

              	
                108.68

              	
                73.55

              	
                141.25

              	
                78.79

              	
                272.69

              	
                175.02

              	
                367.01

              	 	
                10,832.06

              	
                1,590.33

              	
                479.12

              	
                231.41

              	
                252.65

              	
                803.51

              	
                795.28

              	 	
                285.34

              	 	
                90.23

              	
                73.78

              
	
                07

              	
                1,129.82

              	
                204.45

              	
                109.26

              	
                72.86

              	
                141.73

              	
                78.32

              	
                273.61

              	
                175.02

              	
                365.72

              	 	
                11,163.75

              	
                1,640.71

              	
                493.91

              	
                239.08

              	
                260.81

              	
                827.63

              	
                819.57

              	 	
                327.95

              	 	
                92.07

              	
                75.80

              
	
                08

              	
                1,059.96

              	
                192.37

              	
                103.85

              	
                71.00

              	
                135.63

              	
                75.86

              	
                258.89

              	
                165.92

              	
                347.91

              	 	
                9,491.27

              	
                1,388.80

              	
                418.74

              	
                201.65

              	
                220.10

              	
                697.76

              	
                689.72

              	 	
                192.42

              	 	
                87.56

              	
                71.84

              
	
                09

              	
                1,098.83

              	
                197.97

              	
                106.55

              	
                71.94

              	
                138.82

              	
                76.90

              	
                263.60

              	
                168.12

              	
                350.22

              	 	
                10,597.24

              	
                1,556.57

              	
                468.33

              	
                226.14

              	
                246.67

              	
                783.66

              	
                775.11

              	 	
                205.41

              	 	
                93.64

              	
                77.21

              
	
                10

              	
                1,119.47

              	
                203.02

              	
                109.37

              	
                74.20

              	
                142.30

              	
                79.38

              	
                271.88

              	
                173.80

              	
                364.21

              	 	
                13,743.02

              	
                2,028.55

              	
                610.42

              	
                297.23

              	
                324.82

              	
                1,028.88

              	
                1,019.25

              	 	
                257.57

              	 	
                107.61

              	
                88.64

              
	
                11

              	
                1,448.97

              	
                260.42

              	
                139.96

              	
                93.84

              	
                182.33

              	
                100.72

              	
                345.33

              	
                219.69

              	
                456.75

              	 	
                14,396.53

              	
                2,111.57

              	
                635.86

              	
                306.49

              	
                335.43

              	
                1,062.07

              	
                1,050.84

              	 	
                339.69

              	 	
                163.96

              	
                133.12

              
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 


      

       

      AHCA Contract No. FA619, Attachment
        III-B, Page 3 of 5

       

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

        
          	
                  ATTACHMENT
                    III-B

                
	
                  September
                    1, 2007- August 31,
                    2008

                
	
                  MEDICAID
                    Non-Reform HMO CAPITATION
                    RATES

                
	
                  By
                    Area , Age and Eligibility
                    Category

                  Estimated
                    Health Plan Rates (Not for use unless approved by
                    CMS)

                


        

         

      

      
        	
                TABLE
                  7

              	 	 	 	 	 	 	 	 	 
	
                General
                  + Dental + Transportation
                  Rates:

              	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	
                TANF

              	 	
                 SSI-N

              	 	
                SSI-B

              	 	
                SSI-AB

              
	
                Area

              	
                BTHMO

                +2MO

              	
                3MO-11MO

              	
                AGE

                 (1-5)

              	
                AGE


                (6-13)

              	
                AGE


                (14-20)

              	
                AGE


                (21-54)

              	
                AGE


                (55+)

              	 	
                BTHMO

                +2MO

              	
                3MO-11MO

              	
                AGE


                (1-5)

              	
                AGE


                (6-13)

              	
                AGE


                (14-20)

              	
                AGE


                (21-54)

              	
                AGE


                (55+)

              	 	 	 	
                AGE


                (65-)

              	
                AGE


                (65+)

              
	 	 	 	 	 	
                Female

              	
                Male

              	
                Female

              	
                Male

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                01

              	
                1,137.55

              	
                203.70

              	
                108.53

              	
                71.06

              	
                141.59

              	
                77.33

              	
                270.39

              	
                171.91

              	
                354.06

              	 	
                10,125.28

              	
                1,486.92

              	
                443.79

              	
                207.56

              	
                231.54

              	
                738.96

              	
                723.81

              	 	
                278.11

              	 	
                114.32

              	
                90.96

              
	
                02

              	
                1,137.55

              	
                203.70

              	
                108.53

              	
                71.06

              	
                141.59

              	
                77.33

              	
                270.39

              	
                171.91

              	
                354.06

              	 	
                10,125.28

              	
                1,486.92

              	
                443.79

              	
                207.56

              	
                231.54

              	
                738.96

              	
                723.81

              	 	
                278.11

              	 	
                114.32

              	
                90.96

              
	
                03

              	
                1,303.13

              	
                235.26

              	
                126.24

              	
                84.45

              	
                165.38

              	
                91.56

              	
                315.41

              	
                201.79

              	
                418.07

              	 	
                11,381.11

              	
                1,692.20

              	
                505.62

              	
                242.30

              	
                269.39

              	
                855.40

              	
                841.72

              	 	
                281.78

              	 	
                114.32

              	
                90.05

              
	
                04

              	
                1,133.91

              	
                205.01

              	
                109.61

              	
                72.62

              	
                142.80

              	
                78.84

              	
                275.48

              	
                176.44

              	
                366.67

              	 	
                10,720.35

              	
                1,592.24

              	
                475.84

              	
                227.23

              	
                251.97

              	
                805.61

              	
                792.92

              	 	
                338.52

              	 	
                113.05

              	
                89.71

              
	
                05

              	
                1,264.71

              	
                228.73

              	
                123.21

              	
                83.49

              	
                161.46

              	
                89.82

              	
                310.94

              	
                200.00

              	
                415.99

              	 	
                11,809.80

              	
                1,743.82

              	
                524.44

              	
                252.49

              	
                278.96

              	
                881.23

              	
                868.62

              	 	
                238.94

              	 	
                110.75

              	
                87.96

              
	
                06

              	
                1,115.70

              	
                202.89

              	
                109.31

              	
                73.93

              	
                142.65

              	
                79.70

              	
                274.94

              	
                176.76

              	
                369.33

              	 	
                10,866.89

              	
                1,612.82

              	
                483.65

              	
                233.40

              	
                257.57

              	
                819.55

              	
                808.53

              	 	
                290.66

              	 	
                101.83

              	
                81.18

              
	
                07

              	
                1,133.76

              	
                205.43

              	
                109.87

              	
                73.23

              	
                143.09

              	
                79.21

              	
                275.80

              	
                176.71

              	
                367.98

              	 	
                11,201.07

              	
                1,664.80

              	
                498.76

              	
                241.20

              	
                266.08

              	
                844.82

              	
                833.75

              	 	
                333.59

              	 	
                104.20

              	
                83.55

              
	
                08

              	
                1,065.54

              	
                193.77

              	
                104.71

              	
                71.52

              	
                137.56

              	
                77.12

              	
                261.99

              	
                168.31

              	
                351.11

              	 	
                9,532.61

              	
                1,415.49

              	
                424.12

              	
                204.01

              	
                225.93

              	
                716.80

              	
                705.44

              	 	
                198.50

              	 	
                102.36

              	
                81.29

              
	
                09

              	
                1,104.21

              	
                199.31

              	
                107.39

              	
                72.45

              	
                140.68

              	
                78.11

              	
                266.59

              	
                170.43

              	
                353.30

              	 	
                10,640.43

              	
                1,584.45

              	
                473.95

              	
                228.61

              	
                252.77

              	
                803.54

              	
                791.53

              	 	
                212.33

              	 	
                109.45

              	
                87.29

              
	
                10

              	
                1,123.26

              	
                203.96

              	
                109.95

              	
                74.56

              	
                143.60

              	
                80.24

              	
                273.99

              	
                175.42

              	
                366.38

              	 	
                13,782.15

              	
                2,053.82

              	
                615.50

              	
                299.47

              	
                330.35

              	
                1,046.90

              	
                1,034.13

              	 	
                264.87

              	 	
                125.27

              	
                99.90

              
	
                11

              	
                1,452.23

              	
                261.23

              	
                140.46

              	
                94.15

              	
                183.45

              	
                101.46

              	
                347.14

              	
                221.09

              	
                458.62

              	 	
                14,425.91

              	
                2,130.54

              	
                639.67

              	
                308.17

              	
                339.58

              	
                1,075.60

              	
                1,062.02

              	 	
                344.61

              	 	
                176.47

              	
                141.10

              
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                TABLE
                  8

              	 	 	 	 	 	 	 	 
	
                General
                  + Mental Health + Dental +
                  Transportation Rates:

              	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	
                TANF

              	 	
                 SSI-N

              	 	
                SSI-B

              	 	
                SSI-AB

              
	
                Area

              	
                BTHMO

                +2MO

              	
                3MO-11MO

              	
                AGE


                (1-5)

              	
                AGE


                (6-13)

              	
                AGE


                (14-20)

              	
                AGE


                (21-54)

              	
                AGE


                (55+)

              	 	
                BTHMO

                +2MO

              	
                3MO-11MO

              	
                AGE


                (1-5)

              	
                AGE


                (6-13)

              	
                AGE


                (14-20)

              	
                AGE


                (21-54)

              	
                AGE


                (55+)

              	 	 	 	
                AGE


                (65-)

              	
                AGE


                (65+)

              
	 	 	 	 	 	
                Female

              	
                Male

              	
                Female

              	
                Male

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                01

              	
                1,137.57

              	
                203.72

              	
                110.17

              	
                82.75

              	
                152.51

              	
                88.25

              	
                274.83

              	
                176.35

              	
                357.81

              	 	
                10,125.36

              	
                1,487.00

              	
                451.23

              	
                255.60

              	
                275.52

              	
                820.34

              	
                754.79

              	 	
                278.32

              	 	
                125.97

              	
                102.61

              
	
                02

              	
                1,137.58

              	
                203.73

              	
                111.44

              	
                91.31

              	
                155.00

              	
                90.74

              	
                273.80

              	
                175.32

              	
                357.02

              	 	
                10,125.44

              	
                1,487.08

              	
                457.58

              	
                286.36

              	
                276.75

              	
                791.63

              	
                748.68

              	 	
                298.31

              	 	
                129.32

              	
                105.96

              
	
                03

              	
                1,303.14

              	
                235.27

              	
                127.56

              	
                93.63

              	
                171.46

              	
                97.64

              	
                316.96

              	
                203.34

              	
                419.41

              	 	
                11,381.18

              	
                1,692.27

              	
                511.88

              	
                278.05

              	
                289.90

              	
                879.29

              	
                853.00

              	 	
                288.63

              	 	
                123.30

              	
                99.03

              
	
                04

              	
                1,133.92

              	
                205.02

              	
                110.98

              	
                82.18

              	
                149.13

              	
                85.17

              	
                277.09

              	
                178.05

              	
                368.06

              	 	
                10,720.46

              	
                1,592.35

              	
                485.59

              	
                282.96

              	
                283.94

              	
                842.86

              	
                810.51

              	 	
                363.07

              	 	
                129.82

              	
                106.48

              
	
                05

              	
                1,264.72

              	
                228.74

              	
                124.42

              	
                92.16

              	
                169.57

              	
                97.93

              	
                314.23

              	
                203.29

              	
                418.77

              	 	
                11,809.85

              	
                1,743.87

              	
                529.46

              	
                284.90

              	
                308.63

              	
                936.13

              	
                889.52

              	 	
                241.67

              	 	
                123.56

              	
                100.77

              
	
                06

              	
                1,115.72

              	
                202.91

              	
                111.16

              	
                87.17

              	
                155.03

              	
                92.08

              	
                279.97

              	
                181.79

              	
                373.58

              	 	
                10,866.96

              	
                1,612.89

              	
                490.17

              	
                275.50

              	
                296.11

              	
                890.86

              	
                835.67

              	 	
                291.97

              	 	
                105.71

              	
                85.06

              
	
                07

              	
                1,133.78

              	
                205.45

              	
                111.65

              	
                85.91

              	
                154.94

              	
                91.06

              	
                280.62

              	
                181.53

              	
                372.05

              	 	
                11,201.13

              	
                1,664.86

              	
                504.88

              	
                280.70

              	
                302.24

              	
                911.74

              	
                859.22

              	 	
                336.18

              	 	
                114.71

              	
                94.06

              
	
                08

              	
                1,065.55

              	
                193.78

              	
                105.97

              	
                80.32

              	
                143.39

              	
                82.95

              	
                263.47

              	
                169.79

              	
                352.39

              	 	
                9,532.68

              	
                1,415.56

              	
                430.12

              	
                238.29

              	
                245.60

              	
                739.71

              	
                716.26

              	 	
                205.35

              	 	
                115.58

              	
                94.51

              
	
                09

              	
                1,104.23

              	
                199.33

              	
                108.94

              	
                83.26

              	
                147.84

              	
                85.27

              	
                268.41

              	
                172.25

              	
                354.88

              	 	
                10,640.50

              	
                1,584.52

              	
                480.28

              	
                264.75

              	
                273.51

              	
                827.69

              	
                802.94

              	 	
                219.18

              	 	
                119.04

              	
                96.88

              
	
                10

              	
                1,123.28

              	
                203.98

              	
                111.87

              	
                87.92

              	
                152.45

              	
                89.09

              	
                276.24

              	
                177.67

              	
                368.33

              	 	
                13,782.24

              	
                2,053.91

              	
                623.85

              	
                347.17

              	
                357.72

              	
                1,078.78

              	
                1,049.18

              	 	
                271.72

              	 	
                133.32

              	
                107.95

              
	
                11

              	
                1,452.25

              	
                261.25

              	
                142.08

              	
                105.44

              	
                190.93

              	
                108.94

              	
                349.04

              	
                222.99

              	
                460.27

              	 	
                14,425.99

              	
                2,130.62

              	
                646.64

              	
                347.96

              	
                362.41

              	
                1,102.20

              	
                1,074.58

              	 	
                351.84

              	 	
                184.52

              	
                149.15

              
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 


      

       

      AHCA Contract No. FA619, Attachment
        III-B, Page 4 of 5

       

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

        
          	
                  ATTACHMENT
                    III-B

                
	
                  September
                    1, 2007- August 31,
                    2008

                
	
                  MEDICAID
                    Non-Reform HMO CAPITATION
                    RATES

                
	
                  By
                    Area , Age and Eligibility
                    Category

                  Estimated
                    Health Plan Rates (Not for use unless approved by
                    CMS)

                


        

         

      

      
        	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                Area

              	 	
                Corresponding
                  Counties

              	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                Area
                  1

              	 	
                Escambia,
                  Okaloosa, Santa Rosa,
                  Walton

              	 	 	 	 	 
	
                Area
                  2

              	 	
                Bay,
                  Calhoun, Franklin, Gadsden,
                  Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Taylor,
                  Washington, Wakulla

              
	
                Area
                  3

              	 	
                Alachua,
                  Bradford, Citrus,
                  Columbia, Dixie, Gilchrist, Hamiliton, Hernando, Lafayette, Lake,
                  Levy,
                  Marion, Putnam, Sumter, Suwannee, Union

              
	
                Area
                  4

              	 	
                Baker,
                  Clay, Duval, Flagler,
                  Nassau, St. Johns, Volusia

              	 	 	 
	
                Area
                  5

              	 	
                Pasco,
                  Pinellas

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                Area
                  6

              	 	
                Hardee,
                  Highlands, Hillsborough,
                  Manatee, Polk

              	 	 	 	 	 	 
	
                Area
                  7

              	 	
                Brevard,
                  Orange, Osceola,
                  Seminole

              	 	 	 	 	 	 	 	 	 
	
                Area
                  8

              	 	
                Charlotte,
                  Collier, De Soto,
                  Glades, Hendry, Lee, Sarasota

              	 	 	 	 	 
	
                Area
                  9

              	 	
                Indian
                  River, Okeechobee, St.
                  Lucie, Martin, Palm Beach

              
	
                Area
                  10

              	 	
                Broward

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                Area
                  11

              	 	
                Dade,
                  Monroe

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                Created
                  on August 10,
                  2007

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 


      

    

     

    AHCA Contract No. FA619, Attachment
      III-B, Page 5 of 5