exv10w7






Exhibit 10.7




	 	 	 	 	 
	 

	 		 	 
	 

	 	Department of Human Services	 	 
	 

	 	Division of Medical Assistance And Health Services	 	 
	 

	 	PO Box 712	 	 
	Jon S. Corzine

	 	Trenton NJ 08625-0712
	 	Jennifer Velez
	Governor

	 	Telephone 1-800-356-1561
	 	Commissioner
	 

	 	 	 	 
	 

	 	 	 	John R. Guhl
	 

	 	May 8, 2008
	 	Director






Peter D. Haytaian

President and Chief Executive Officer

AMERIGROUP New Jersey, Inc.

399 Thornall Street, 9th Floor

Edison, NJ 8837



Dear Mr. Haytaian:



Enclosed is an HMO contract amendment that extends the contract for one year to June 30,
2009 with the new capitation rate, effective July 1, 2008. All other terms of the current
contract remain in full force and effect. We are rescinding the previous contract amendment
that would have extended the HMO contract for one month to July 31, 2008.



Please review and return five original signed copies to the Office of Managed Health Care
by May 21, 2008. If you have any questions, please do not hesitate to call me at 609-588-2705.




	 	 	 	 	 
	 	Sincerely,

 	 
	 	
 	 
	 	Jill Simone, MD 	 
	 	Executive Director

Office of Managed Health Care 	 
	 



JS

Enclosure





			
	c:	 	John R. Guhl

David Lowenthal

John Koehn





New Jersey Is An Equal Opportunity Employer • Printed on Recycled Paper and Recyclable




 









 








STATE OF NEW JERSEY




DEPARTMENT OF HUMAN SERVICES




DIVISION
OF MEDICAL ASSISTANCE AND HEALTH SERVICES




AND




AMERIGROUP NEW JERSEY, INC.




AGREEMENT TO PROVIDE HMO SERVICES



In accordance with Article 7, sections 7.11.2A, 7.11.2B, and 7.12.1 of the contract between
AMERIGROUP New Jersey, Inc. and the State of New Jersey, Department of Human Services, Division
of Medical Assistance and Health Services (DMAHS), effective date October 1, 2000, all parties
agree that the contract shall be amended, effective July 1, 2008, as follows:



Appendix,
Section C, “Capitation Rates” shall be revised as reflected in SFY
2009 Capitation Rates attached hereto and incorporated herein.





 









 




All other terms and conditions of the October 1, 2000 contract and subsequent
amendments remain unchanged except as noted above.



The contracting parties indicate their agreement by their signature.




	 	 	 	 	 	 	 	 	 
	AMERIGROUP NEW JERSEY, INC.	 	 	 	 	 	State of New Jersey
	 

	 	 	 	 	 	 	 	Department of Human Services
	 
	 	 	 	 	 	 	 	 
	BY:

	 	 	 	 	 	BY:	 	 
	 

	 	 
	 	 	 	 	 	 
	 

	 	 	 	 	 	 	 	John R. Guhl
	 
	 	 	 	 	 	 	 	 
	TITLE:

	 	President & CEO
	 	 	 	TITLE:
	 	DIRECTOR, DMAHS
	 

	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 
	DATE:

	 	May 13, 2008
	 	 	 	DATE:	 	 
	 

	 	 
	 	 	 	 	 	 





	 	 	 	 	 
	 

	 	APPROVED AS TO FORM ONLY
	 	 
	 
	 	 	 	 
	 

	 	Anne Milgram	 	 
	 
	 	 	 	 
	 

	 	ATTORNEY GENERAL	 	 
	 
	 	 	 	 
	 

	 	STATE OF NEW JERSEY	 	 
	 
	 	 	 	 
	BY:

	 	 	 	 
	 

	 	 	 	 
	 
	 	 	 	 
	 

	 	Deputy Attorney General	 	 
	 
	 	 	 	 
	DATE:
	 	 	 	 
	 

	 	 	 	 





 









 





SFY09 Rates

Contract Period: 07/01/08 - 06/30/09




	 	 	 	 	 	 	 	 	 	 	 
	Category	 	Age/Sex	 	Northern	 	Central	 	Southern	 	Statewide
	AFDC / DYFS / KidCare A / New Jersey Care Children

	 	Newborn	 	 	 	 	 	 	 	 
	AFDC / DYFS / KidCare A / New Jersey Care Children

	 	75 dys - 2 yrs M&F	 	 	 	 	 	 	 	 
	AFDC / DYFS / KidCare A / New Jersey Care Children / NJCPW

	 	2 - 20.99 M&F	 	 	 	 	 	 	 	 
	AFDC / NJCPW

	 	21 - 44.99 Female	 	 	 	 	 	 	 	 
	AFDC

	 	21 - 44.99 Male	 	 	 	 	 	 	 	 
	AFDC
/ NJCPW

	 	45+ M&F	 	 	 	 	 	 	 	 
	Non ABD-DDD (including Home Health Add-On)

	 	All	 	 	 	 	 	 	 	 
	Aged with Medicare

	 	All	 	 	 	 	 	 	 	 
	Blind/Disabled with Medicare and Other Dual Eligibles

	 	< 45 M&F	 	 	 	 	 	 	 	 
	Blind/Disabled with Medicare and Other Dual Eligibles

	 	45+ M&F	 	 	 	 	 	 	 	 
	ABD-DDD with Medicare and Other Dual Eligibles

	 	All	 	 	 	 	 	 	 	 
	ABD (including AIDS & DDD) without Medicare	 	All	 	***REDACTED***

	KidCare B&C

	 	Newborn	 	 	 	 	 	 	 	 
	KidCare B&C

	 	< 2 M&F	 	 	 	 	 	 	 	 
	KidCare B&C

	 	Youth	 	 	 	 	 	 	 	 
	KidCare D

	 	Newborn	 	 	 	 	 	 	 	 
	KidCare D

	 	< 2 M&F	 	 	 	 	 	 	 	 
	KidCare D

	 	Youth	 	 	 	 	 	 	 	 
	FamilyCare Parents 0-200% / FamilyCare Adults and Health Access / Adult Restricted Aliens

	 	21 - 44.99 Female	 	 	 	 	 	 	 	 
	FamilyCare Parents 0-200% / FamilyCare Adults and Health Access / Adult Restricted Aliens

	 	21 - 44.99 Male	 	 	 	 	 	 	 	 
	FamilyCare Parents 0-200% / FamilyCare Adults and Health Access /Adult Restricted Aliens

	 	45+ M&F	 	 	 	 	 	 	 	 
	AIDS-ABD with Medicare and Other Dual Eligibles

	 	All	 	 	 	 	 	 	 	 
	AIDS-Non-ABD

	 	All	 	 	 	 	 	 	 	 
	AIDS-ABD with Medicare and Other Dual Eligibles DDD (Including Behavioral Health Add-On)

	 	All	 	 	 	 	 	 	 	 
	AIDS-Non-ABD DDD (including Behavioral Health Add-On)

	 	All	 	 	 	 	 	 	 	 
	Add-On-Behavioral Health-DDD w/ Medicare

	 	All	 	 	 	 	 	 	 	 
	Add-On-Behavioral Health-DDD w/o Medicare

	 	All	 	 	 	 	 	 	 	 
	Maternity

	 	All	 	 	 	 	 	 	 	 





Note:

The ABD without Medicare rate above assume a 1.00 Risk Adjustment Rate Factor. This SFY09
rates represent the average of the FFS and HMO populations.
The expected SFY09 HMO average risk score factors is less than 1.00.