Exhibit 10.167


 


Amendment to the January 1, 2001
CaliforniaCare Medical Services Agreement between Blue Cross of California and
its Affiliates and Prospect Health Source Medical Group, effective
January 1, 2001


 












*** Confidential
Treatment requested


 

















 


AMENDMENT

CALIFORNIACARE MEDICAL SERVICES AGREEMENT


 


This
Amendment to the CaliforniaCare Medical Services Agreement is entered into at
Woodland Hills, Los Angeles County, California, as of January 1, 2001 between Blue Cross of
California and its Affiliates (“BLUE CROSS”) and Prospect Health Source Medical Group  (“PARTICIPATING
MEDICAL GROUP”).


 


RECITALS


 


A.                                   BLUE CROSS and PARTICIPATING
MEDICAL GROUP have previously entered into a CaliforniaCare Medical Services
Agreement effective January 1, 2001 whereby
PARTICIPATING MEDICAL GROUP is designated as a Participating Medical
Group.  The forgoing agreement and any
amendments thereto shall be referred to herein as the “Agreement”.


 


B.                                     Pursuant to Section 16.01
of the Agreement, the parties now desire to amend the Agreement as set forth
below.


 


NOW,
THEREFORE, IT IS AGREED:


 


I.                                         Section 4.02H(5) of the Agreement is deleted in its
entirety and is hereby replaced with the following:


 


Members may directly access PARTICIPATING MEDICAL GROUP
Physicians in the following specialties without the prior authorization of
PARTICIPATING MEDICAL GROUP’s Utilization Management Program:


 


(a)          Dermatology


(b)         Allergy


(c)          Obstetrics/Gynecology


(d)         Ear, Nose and Throat


 


In addition to any other amounts due hereunder,
PARTICIPATING MEDICAL GROUP shall receive a payment of *** PMPM (not adjusted
for Member Age/Sex Factors or Benefit Plan Factors) for each Member assigned to
PARTICIPATING MEDICAL GROUP who is entitled under the Member’s Benefit
Agreement to direct access for all four of the above-mentioned specialities.


 


II.                                     Section 13.05 of the Agreement is hereby added to read
as follows:


 


This Agreement may be terminated
by BLUE CROSS immediately in the event PMG fails to satisfy BLUE CROSS’
criteria, including but limited to, medical, legal and financial.  Determination as to whether PMG meets BLUE
CROSS’ criteria shall be solely within the discretion of BLUE CROSS.


 


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Upon
acceptance of the parties, this Amendment, as of the date specified on page one
hereof, shall become a part of the Agreement, and all provisions of the
Agreement not specifically inconsistent herewith shall remain in full force and
effect.


 


 


	
  BLUE CROSS OF
  CALIFORNIA

  	
  PARTICIPATING
  MEDICAL GROUP

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
  Signature:

  	
  /s/ Barry
  Ford

  	
   

  	
  Signature:

  	
  /s/ Peter
  G. Goll

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
  Name: Barry Ford

  	
  Name:

  	
  Peter G. Goll

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
  Title:

  	
  Vice President

  	
   

  	
  Title:

  	
  Senior Vice President

  	
   

  
	
   

  	
  Network Development
  & Management

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
  Data:

  	
  1-18-01

  	
   

  	
  Data:

  	
  1-3-01

  	
   

  
											



 


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