Contract Amendment effective as of July 1, 2005



 Exhibit 10.1 
  
 U T A H   D E P A R T M E N T   O F   H E A L T H 
 Box 3104 
 288 North 1460 West, Salt Lake City,
Utah 84114-3104 
  
 C O N T R A C T   A M E N D M E N
T 
  

			
	 H9920205-13                  
 Department Log Number
	 	         006146
 State Contract Number


 Amendment Number 13 
  

	1.	CONTRACT NAME: 

 The name of this Contract is HMO –
AFC/Molina. 
  

	2.	CONTRACTING PARTIES: 

 This Contract Amendment is between
the Utah Department of Health (DEPARTMENT), and Molina Healthcare of Utah (CONTRACTOR). 
  

	3.	PURPOSE OF CONTRACT AMENDMENT: 

 To extend the termination
date of the Contract for six months; increase the Contract Amount by $60,000,000.00; and modify Attachment F-4 by replacing Provisions C (CHEC Screening Incentive Clause) and D (Immunization Incentive Clause). 
  

	4.	CHANGES TO CONTRACT: 

  

	 	A.	Effective July 1, 2005, on page 1, paragraph 3, CONTRACT PERIOD, is changed to read as follows: 

 “The service period of this Contract will be July 1, 1999 through December 31, 2005, unless terminated or extended by
agreement in accordance with the terms and conditions of this Contract. 
  

	 	B.	Effective July 1, 2005, on page 1, paragraph 4, CONTRACT AMOUNT, is changed to read as follows: 

 “The CONTRACTOR will be paid up to a maximum of $400,000,000.00 in accordance with the provisions in this Contract. This Contract is funded
with 71.11% Federal funds and with 28.89% State funds. The CFDA # is 93.778 and relates to the federal funds provided.” 
  

	 	C.	Effective July 1, 2004, on page 2 of Attachment F-4, Payment Methodology, Section C. “CHEC Screening Incentive Clause” is replaced with the following:


  

	 	“C.	CHEC SCREENING INCENTIVE CLAUSE 

  

	 	1.	CHEC Screening Goal 

  
 The CONTRACTOR will ensure that Medicaid children have access to appropriate well-child visits. The CONTRACTOR will follow the Utah EPSDT (CHEC)
guidelines for the periodicity schedule for well-child protocol. The federal agency, Centers for Medicare and Medicaid Services (CMS), mandates that all states have 80% of all children screened. The DEPARTMENT and the CONTRACTOR will work toward
that goal. 
  

	 	2.	Calculation of CHEC Incentive Payment 

  
 The DEPARTMENT will calculate the CONTRACTOR’s annual participation rate based on information supplied by the CONTRACTOR under the CMS-416 EPSDT
(CHEC) reporting requirements. Based on the CMS-416 data, the CONTRACTOR’s well-child participation rate was 67% for Federal Fiscal Year (FFY) 2003 (October 1, 2002 through September 30, 2003). The incentive payment for the Contract year
ending June 30, 2005 will be based on the CONTRACTOR’s FFY 2004 (October 1, 2003 through September 30, 2004) CMS-416 participation rate. The DEPARTMENT will pay the CONTRACTOR $10,000 if a rate of 80% or higher is attained during FFY
2004. 
  
 The participation rate will be calculated no later
than June 1, 2005; the CONTRACTOR will be notified of the incentive payment, if applicable, no later than June 30, 2005. 
  

	 	3.	CONTRACTOR’s Use of Incentive Payment 

  
 The CONTRACTOR agrees to use this incentive payment to reward the CONTRACTOR’s employees responsible for improving the EPSDT (CHEC) participation
rate.” 
  

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	 	D.	Effective July 1, 2004, on page 3 of Attachment F-4, Payment Methodology, Section D. “Immunization Incentive Clause” is replaced with the following:


  

	 	D.	IMMUNIZATION INCENTIVE CLAUSE 

  
 The CONTRACTOR will ensure that Enrollees have access to recommended immunizations. The CONTRACTOR will follow the Advisory Committee on Immunization
Practices’ recommendations for immunizations for children. 
  

	 	1.	Immunizations for two-year-olds 

  
 The National Immunization Survey reported that in 2003 Utah had a statewide immunization level of 78.8% for two-year-olds. The CONTRACTOR’s 2002
HEDIS rate was 57% for the Combination 1 immunization measure for two-year olds. Based on the CONTRACTOR’s 2003 HEDIS result for the Combination 1 immunization measure, the DEPARTMENT will pay the CONTRACTOR $300 for each full percentage point
above 57%. 
  
 The CONTRACTOR agrees to use this incentive
payment to reward the CONTRACTOR’s employees responsible for improving the HEDIS immunization rate for two-year olds. 
  

	 	2.	Immunizations for adolescents 

  
 The DEPARTMENT realizes it is important that adolescents are vaccinated according to schedule as recommended by the Advisory Committee on Immunization
Practices and other professional groups. The CONTRACTOR’s 2002 HEDIS rate was 7.8% for the Combination 1 immunization measure for adolescents. Based on the CONTRACTOR’s 2003 HEDIS measure for adolescent immunizations, the DEPARTMENT will
pay the CONTRACTOR $300 for each full percentage point above 7.8% up to 57.8%. 
  
 The CONTRACTOR agrees to use this incentive payment to reward the CONTRACTOR’s employees responsible for improving the HEDIS immunization rate for adolescents. 
  

	 	3.	Immunizations for adults 

  
 The DEPARTMENT will provide an incentive to the CONTRACTOR using an influenza measure developed by the DEPARTMENT and the Office of Health Care
Statistics. The measurement is the percentage of Enrollees age 50 and older who receive an influenza immunization during the previous year’s flu season (September 1 of the previous year through May 31 of the measurement year). The baseline
year is September 1, 2002 through August 31, 2003. Based on the CONTRACTOR’s percentage for the flu season ending in 2004, the DEPARTMENT will pay the CONTRACTOR $300 for each full percentage point above the CONTRACTOR’s
percentage in the baseline year up to 50 percentage points above the baseline year. 
  
 The CONTRACTOR agrees to use this incentive payment to reward the CONTRACTOR’s employees responsible for improving the influenza immunization rate for adults. 
  

	 	E.	All other provisions of the Agreement remain unchanged. 

  

	5.	EFFECTIVE DATE OF AMENDMENT: This amendment is effective July 1, 2005 for Changes A and B, and July 1, 2004 for changes in the provisions under Change C and
Change D. 

  

	6.	If the Contractor is not a local public procurement unit as defined by the Utah Procurement Code (UCA § 63-56-5), this Contract Amendment must be signed by a representative of
the State Division of Finance and the State Division of Purchasing to bind the State and the Department to this Contract Amendment. 

  

	7.	This Contract, its attachments, and all documents incorporated by reference constitute the entire agreement between the parties and supercede all prior negotiations,
representations, or agreements, either written or oral between the parties relating to the subject matter of this Contract. 

  

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 IN WITNESS WHEREOF, the parties sign this Contract Amendment. 
  
  
  

					
	 CONTRACTOR:         Molina Healthcare of Utah
  
  
 By:
        /s/ Kirk Olsen                    
        Signature of Authorized Individual         Date
  
 Print Name:         Kirk Olsen
  
 Title:         Chief Executive
Officer
  
         33-0617992
 Federal Tax Identification Number or
     Social Security Number
	  	 UTAH DEPARTMENT OF HEALTH
  
  
 By:         /s/ Shari
Watkins                                    
        Shari A. Watkins, C.P.A.
        Director
        Office of Fiscal Operations
  
                                      
                                        
                           
 State Finance:
  
                                      
                                        
                           
 State Purchasing:
	    	  
  
  

 
  
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