Exhibit
10.98


 


AMENDMENT


to the

PROVIDER SERVICES AGREEMENT


between

HEALTH NET, INC. AFFILIATES


and


Professional Care Medical Group IPA


 


The Provider Services Agreement (“Agreement”),
dated March 1, 1999, between Professional Care Medical Group, IPA (“PPG”) and
Health Net, Inc. Affiliates (“HNI”), as subsequently amended, is hereby amended
effective January 1, 2004 as follows:


 


1.                                       Addendum C. B. MEDICARE HMO
BENEFIT PROGRAMS, Section
2, a new Subsection 2.1.1 shall be added as follows:


 


2.1.1  Compensation
for PPG Capitated Services for Unidentified Medi-Medi HMO Members


Unidentified Medi-Medi HMO
Members shall be defined as Medicare HMO Members not identified by HNI as
Members with both Medicare and Medi-Cal coverage on or after the date of this
amendment.  Compensation for rendering
PPG Capitated Services to such Unidentified Medi-Medi HMO Members shall be at
the same percent of Monthly Revenue set forth in Section 2.1 of Addendum C
minus a *** vendor fee.  The vendor fee
shall only be paid on the difference between the Monthly Revenue for an
Unidentified Medi-Medi HMO Member before such Member qualified for enhanced
benefits and the Monthly Revenue after such Member qualified for enhanced
benefits and shall be deducted prior to calculating the compensation to
PPG.  This compensation shall be in
addition to the compensation set forth in Section 2.1 above.


 


The effective date of payment
for PPG Capitated Services pursuant to this Section 2.1.1 for an Unidentified
Medi-Medi HMO Member shall be the date the Unidentified Medi-Medi HMO Member
qualifies for enhanced benefits as determined by CMS.  HNI shall pay the enhanced revenue to PPG for an Unidentified
Medi-Medi HMO Member as set forth herein only after HNI is paid for enhanced
benefits by CMS for such Member.  CMS
may retroactively qualify an Unidentified Medi-Medi HMO Member.  In such case, payment to Provider shall be
based on the percent of Monthly Revenue for each month of retroactive CMS
payment.


 


Except for the additional
amount set forth above, Capitation for an Unidentified Medi-Medi HMO Member
shall be paid in accordance with this Addendum C, and all provisions of this
Addendum C applicable to the payment of Capitation shall apply to the
Capitation payment for Unidentified Medi-Medi HMO Members.  In the event of a Capitation error for
Unidentified Medi-Medi HMO Members, resulting in an overpayment or underpayment
to PPG, HMO shall adjust subsequent Capitation to offset such error.


 


Except as so amended, all other provisions of
the Agreement shall remain unchanged and in effect:


 


IN WITNESS
WHEREOF, the parties
hereto have executed this Amendment by their offices duly authorized to be
effective on the date and year first written above.


 


	
  Professional
  Care Medical Group IPA

  	
   

  	
  Health
  Net, Inc. Affiliates

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
  /s/ [ILLEGIBLE]

  	
   

  	
   

  	
  /s/ Jenni Vargas

  	
   

  
	
  Signature 

  	
   

  	
  Jenni Vargas

  
	
   

  	
   

  	
   

  
	
  VICE
  PRESIDENT - CONTRACTING

  	
   

  	
   

  	
  Network Management and
  Development Officer

  
	
  Title

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
  12/4/03

  	
   

  	
   

  	
   

  	
  12/7/03

  	
   

  
	
  Date

  	
   

  	
  Date

  
									



 


 


 












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separately with the Securities and Exchange Commission.