far009amend5.htm


    
      

    

    Back
      to Form 8-K

    Exhibit
      10.4


    AHCA
      CONTRACT NO. FAR009

    AMENDMENT
      NO. 5

    


    THIS
      CONTRACT, entered into between the STATE OF FLORIDA, AGENCY FOR HEALTH
      CARE ADMINISTRATION, hereinafter referred to as the “Agency,” and
WELLCARE OF FLORIDA, INC. D/B/A STAYWELL HEALTH PLAN OF
      FLORIDA, hereinafter referred to as the “Vendor,” is hereby amended as
      follows:

    


    
      	
              
                1.

              

            	
               

            	
              Attachment
                I, Exhibit 6-A, is hereby deleted in its entirety and replaced with
                Exhibit 6-B, attached hereto and made a part of the
                Contract.  All references in the Contract to Exhibit 6-A shall
                hereinafter refer to Exhibit 6-B.

            


    

    


    This
      Amendment shall have an effective
      date of September 1, 2007, or the date on which both parties execute the
      Amendment, whichever is later.

    


    All
      provisions in the Contract and any
      attachments thereto in conflict with this Amendment shall be and are hereby
      changed to conform with this Amendment.

    


    All
      provisions not in conflict with
      this Amendment are still in effect and are to be performed at the level
      specified in the Contract

    


    This
      Amendment, and all its
      attachments, is hereby made part of the Contract.

    


    This
      Amendment cannot be executed
      unless all previous Amendments to this Contract have been fully
      executed.

    


    IN
      WITNESS WHEREOF, the parties hereto
      have caused this two (2) page Amendment (including all attachments) to be
      executed by their officials thereunto duly authorized.

    


    


    


    
      	
              WELLCARE
                OF FLORIDA, INC. D/B/A STAYWELL HEALTH PLAN OF FLORIDA,
                INC.

            	 	
              STATE
                OF FLORIDA, AGENCY FOR HEALTH CARE
                ADMINISTRATION

            
	
              SIGNED
                BY:  /s/  Todd S. Farha

            	 	
              SIGNED
                BY: /s/  Andrew Agwunobi

            
	
              NAME:  Todd
                S. Farha

            	 	
              NAME:  Andrew
                C. Agwunobi, M.D.

            
	
              TITLE:  CEO

            	 	
              TITLE:  Secretary

            
	
              DATE:  9/4/07

            	 	
              DATE: 9/6/07

            


    

     

    
      	
              List
                of Attachments/Exhibits included as part of this
                Amendment:

               

            
	
              Specify
                Type

            	
              Letter/
                Number

            	
              Description

            
	
              Exhibit

            	
              6-B

            	
              Capitation
                Rates for HIV/AIDS Populations for each

              Medicaid
                Reform County (1 page)

            


    

    



    
      
        
          AHCA
            Contract No. FAR009, Amendment No. 5, Page 1 of
            1

          AHCA
            Form
            2100-0002 (Rev. NOV03)     

        

        
        

      

      
        
        

        
          

        

      

      
        
        

      

    


    
      	
               

            	
              EXHIBIT
                6-B

            


    

    
      	
               

            	
              CAPTITATION
                RATES FOR HIV/AIDS POPULATIONS FOR EACH MEDICAID REFORM
                COUNTY

            


    

    


    


    


    
      	
               

            	
              TABLE
                5

            


    

    


    
      	
              Area:      4

            	
              County:
                  Duval, Baker, Clay, and Nassau

            	 


    

     

    ESTIMATED
      HEALTH PLAN RATES (NOT FOR USE UNLESS APPROVED BY CMS)

     

    
      	 	
              Capitation
                Rate

            
	
              HIV
                (no medicare)

            	
              $1,216.29

            
	
              AIDS
                (no medicare)

            	
              $2,394.42

            
	
              HIV-SSI/Parts
                A & B, SSI Part B Only

            	
              $   199.19

            
	
              AIDS-SSI/Parts
                A & B, SSI Part B Only

            	
              $   425.36

            


    

    


    


    


    
      	
              Area:      10

            	
              County:    Broward

            	 


    

    


    ESTIMATED
      HEALTH PLAN RATES (NOT FOR USE UNLESS APPROVED BY CMS)

     

    
      	 	
              Capitation
                Rate

            
	
              HIV
                (no medicare)

            	
              $1,966.44

            
	
              AIDS
                (no medicare)

            	
              $3,690.26

            
	
              HIV-SSI/Parts
                A & B, SSI Part B Only

            	
              $   331.60

            
	
              AIDS-SSI/Parts
                A & B, SSI Part B Only

            	
              $   708.10

            


    

    


    


    REMAINDER
      OF PAGE INTENTIONALLY LEFT BLANK

    



    
      
        AHCA
          Contract No. FAR009, Exhibit 6-B, Page 1 of 1 

          AHCA
            Form
            2100-0002 (Rev. NOV03)