Exhibit
10.118


 


AMENDMENT


to
the

PARTICIPATING PROVIDER AGREEMENT

between

FOUNDATION HEALTH SYSTEMS AFFILIATES

and

PROSPECT MEDICAL GROUP


 


The Provider Services
Agreement dated January 1, 1998 between Prospect Medical Group (“PPG”) and
Foundation Health Systems Affiliate(s) (“FHS”) is hereby amended effective
January 1, 1998.


 


FHS
and PPG hereby agree to amend the Agreement as follows:


 


1.                                       Section 1.10, Emergency, shall be
deleted in its entirety and replaced with the following:


 


1.10         Emergency.  A medical condition manifesting itself by
acute symptoms of sufficient severity such that a prudent layperson who
possesses average knowledge of health and medicine, could reasonably expect the
absence of immediate medical attention to result in: (i) placing the individual
in serious jeopardy (and in the case of a pregnant woman, her health or that of
her unborn child); (ii) serious impairment to bodily functions; or (iii)
serious dysfunction of any bodily organ or part. FHS shall have the final
authority in decisions regarding emergencies and emergency services.


 


2.                                       Section 1.17, Operations Manual, shall
be amended to add the following sentence:


 


PPG
agrees to be contractually bound to comply with the Operations Manual,
including the medical policy manuals, and any updates or revisions to such, to
be issued to PPG.


 


3.                                       Section 4.3, Offsetting, Subsection (d)
shall be amended to add the following sentence:


 


In
no event shall PPG be required to make any cash payments to FHS for any deficit
in a shared risk program for institutional services.


 


4.                                       Section 4.9, Third Party Recoveries,
shall be deleted in its entirety and replaced with the following:


 


4.9           Third Party Recoveries, Worker’s
Compensation.  In the event PPG
provides services to FHS Members for injuries resulting from the acts of third
parties, or resulting from work related injuries, PPG shall have the right to
recover from any settlement, award, or recovery from any responsible
third-party the full value of Covered Services rendered pursuant to the
applicable provisions of the Coverage Certificate and as set forth in the
Operations Manual. PPG shall notify FHS of any third party payor and shall,
upon request from FHS, provide FHS with an accounting of all such sums
recovered.


 


5.                                       Section 4.10, Occupationally Ill/Injured or
Workers’ Compensation shall be deleted in its entirety:


 


The
remainder of Article IV, Compensation, shall be renumbered accordingly.


 


6.                                       Section 6.6, Termination of an Affiliate,
shall be amended to add the following paragraph:


 


In
the event the terminated Affiliate under this Section 6.6 is a licensed health
care service plan, such Affiliate and PPG understand and agree that Sections
6.7, 6.8 and 6.9 of the Agreement shall apply to such Affiliate and the Members
of such Affiliate.


 


7.                                       A new Section 8.5, Provider Dispute
Resolution Procedure, shall be inserted to read as follows:


 


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8.5           Provider Dispute Resolution
Procedure.  FHS has established a
Provider Dispute Resolution Procedure under which PPG may submit disputes to
FHS. The Provider Dispute Resolution Procedure which contains the procedures
for processing and resolving such disputes including the location and telephone
number where information regarding disputes may be submitted, is set forth in
the Operations Manual. Any provider dispute which is not resolved informally
through the Provider Dispute Resolution Procedure may be submitted for
arbitration as provided in Section 8.6 below.


 


The remainder of Article VIII, General
Provisions, is renumbered accordingly.


 


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


 


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