Document:

Exhibit 10.1

    

      Exhibit
        10.1

      STATE
        OF ILLINOIS DEPARTMENT OF PUBLIC AID

       

      AMENDMENT
        NO. 3 TO THE

      CONTRACT
        FOR FURNISHING HEALTH SERVICES BY A MANAGED CARE
        ORGANIZATION

      2004-24-001-KA3

       

      whereas, the
        parties to the Contract for Furnishing Health Services by a Managed Care
        Organization ("CONTRACT"), the
        Illinois Department of Healthcare & Family Services (formerly Public
        Aid),
        201
        South Grand Avenue East, Springfield, Illinois 62763-0001 (herein referred
        to as
        "Department"), acting by and through its Director, and
        Harmony Health Plan of Illinois, Inc.,
        125
        South Wacker Drive, Suite 2600, Chicago, IL 60606 (hereinafter referred to
        as
        "Contractor"), desire to amend the CONTRACT; and

       

      WHEREAS,
        the
        Department is statutorily obligated to amend this Contract to achieve net
        liability savings in its managed care appropriation, and;

       

      WHEREAS,
        the
        Department's actuary has certified that the Contract and rates resulting
        from
        this amendment are actuarially sound;

       

      NOW
        THEREFORE,
        the
        parties agree to amend the contract as follows:

       

      1.
        Article V, Section 5.1 of the contract is amended to read as follows effective
        for dates of service August 1, 2005, and later;

       

      5.1
        Services.

       

      (a)
        Amount,
        Duration and Scope of Coverage.
        The
        Contractor shall comply with the terms of 42 C.F.R. §438.206(b) and provide or
        arrange to have provided to all Enrollees all services described in 89 111.
        Adm.
        Code, Part 140 as amended from time to time and not specifically excluded
        therein or in this Article V, Section 5.1 in accordance with the terms of
        this
        Contract. Covered Services shall be provided in the amount, duration and
        scope
        as set forth in 89 111. Adm. Code, Part 140 and this Contract, and shall
        be
        sufficient to achieve the purposes for which such Covered Services are
        furnished. This duty shall commence at the time of initial coverage as to
        each
        Enrollee. The Contractor shall, at all times, cover the appropriate level
        of
        service (i.e., triage, urgent) for all Emergency Services provided in an
        emergency room setting. The Contractor shall notify the Department in writing
        within five (5) days following a change in the Contractor's network of
        Affiliated Providers that renders the Contractor unable to provide one (1)
        or
        more Covered Service(s) in any Contracting Area. The Contractor shall not
        refer
        Enrollees to publicly supported health care entities to receive Covered
        Services, for which the Contractor receives payment from the Department,
        unless
        such entities are Affiliated with the Contractor's Plan. Such publicly supported
        health care entities include, but are not limited to, Chicago Department
        of
        Public Health and its clinics, Cook County Bureau of Health Services, and
        local
        health departments. The Contractor shall provide a mechanism for an Enrollee
        to

       

       

      
        
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            l

        

        
          
          

          
          

        

        
          
          

        

      

       

      

      obtain
        a
        second opinion from a qualified Provider, whether Affiliated or non-Affiliated,
        at no cost to the Enrollee.

       

      (b)
        Enumerated
        Covered Services.
        The
        Contractor shall have a sufficient number of Affiliated Providers (including
        Tertiary Care hospital(s) and, where appropriate, advanced practice nurses)
        in
        place to provide all of the following services and benefits (which shall
        be
        specifically included as Covered Services under this Contract) to Enrollees
        at
        all times during the term of this Contract, whenever Medically Necessary,
        except
        to the extent services are identified as excluded services pursuant to
        subsection (e) of this Section 5.1:

       

      •
        Assistive/augmentative communication devices;

       

      •
        Audiology services, physical therapy, occupational therapy and speech
        therapy;

       

      •
        Behavioral health services, including subacute alcohol and substance abuse
        services and mental health services, in accordance with subsection (c)
        hereof;

       

      •
Blood,
        blood components and the administration thereof;

       

      •
        Certified hospice services;

       

      •
        Chiropractic services;

       

      •
Clinic
        services (as described in 89 111. Adm. Code, Part 140.460);

       

      •
        Diagnosis and treatment of medical conditions of the eye;

       

      •
Durable
        and nondurable medical equipment and supplies;

       

      •
        Emergency Services;

       

      •
Family
        planning services;

       

      •
Home
        health care services;

       

      •
        Inpatient hospital services (including dental hospitalization in case of
        trauma
        or when related to a medical condition and acute medical
        detoxification);

       

      •
        Inpatient psychiatric care;

       

      •
        Laboratory and x-ray services; The drawing of blood for lead screening shall
        take place within the Contractor's Affiliated facilities or elsewhere at
        the
        Contractor's expense.**

       

      

      _______________________

      *Covered
        Services may be provided by an optometrist operating within the scope of
        his
        license.

       

       

      
        
          
          

        

        
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      •
Medical
        procedures performed by a dentist;

       

      •
Nurse
        midwives services;

       

      •
Nursing
        facility services for the first ninety (90) days;

       

      •
        Orthotic/prosthetic devices, including prosthetic devices or reconstructive
        surgery incident to a mastectomy;

       

      •
        Outpatient hospital services (excluding outpatient behavioral health
        services);

       

      •
        Physicians' services, including psychiatric care;

       

      •
        Podiatric services;

       

      •
Routine
        care in conjunction with certain investigational cancer treatments, as provided
        in Public Act 91-0406;

       

      •
        Services required to treat a condition diagnosed as a result ofEPSDT services,
        in accordance with 89 111. Adm. Code 140.485;

       

      •
        Services to Prevent Illness and Promote Health in accordance with subsection
        (d)
        hereof;

      

      •
        Transplants covered under 89 111. Adm. Code 148.82 (using transplant providers
        certified by the Department, if the procedure is performed in the State);
        and

      

      •
        Transportation to secure Covered Services.

       

      (c)
        Behavioral
        Health Services.

                  

                  (1)
        The Contractor
        will provide the following behavioral health services, which are Covered
        Services:

       

      •
        Inpatient psychiatric or substance abuse services that are provided in general
        hospital medical units;

      

      

      _________________________________

      

      **A11
        laboratory tests for children being screened for lead must be sent for analysis
        to the Illinois Department of Public Health's laboratory.

       

      ***
        Contractors will be responsible for covering up to a maximum of ninety (90)
        days
        nursing facility care (or equivalent care provided at home because a skilled
        nursing facility is not available) annually per Enrollee. Periods in excess
        of
        ninety (90) days annually will be paid by the Department according to its
        prevailing reimbursement system.

       

       

      
        
          
          

        

        
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      •
        Inpatient psychiatric services provided in a hospital that is a psychiatric
        hospital or a distinct psychiatric unit, as defined in 89 111. Adm. Code
        148.40(a)(l);

       

      •
        Inpatient
        acute
        alcoholism and substance abuse treatment (detoxification);

       

      •
        Hospital-based organized clinic services referred to as outpatient treatment
        psychiatric services for Type A and Type B Psychiatric Clinic Services, as
        defined in 89 111. Adm. Code 148.140(b)(l)(E);

       

      •
        Behavioral health services provided
        by
        Physicians, including psychiatrists;

       

      and

       

      •
        Laboratory services provided on an outpatient basis for behavioral health,
        even
        if ordered by a behavioral health provider in connection with the provision
        of
        treatment that is excluded from Covered Services.

       

      (2)
        If an
        Enrollee presents himself to the Contractor for behavioral health services,
        or
        is referred through a third party, the Contractor will complete a behavioral
        health assessment.

       

      
        	•	
                If
                  the assessment indicates that all services needed are within the
                  scope of
                  Covered Services, the Contractor will arrange for the provision
                  of all
                  such Covered Services.

              

      

       

      
        	
              	•	
                If
                  the assessment indicates that outpatient services are needed beyond
                  the
                  scope of Covered Services, the Contractor will explain to the Enrollee
                  the
                  services needed and the importance of obtaining them and provide
                  the
                  Enrollee with a list of Community Behavioral Health Providers (CBHP).
                  The
                  Contractor will assist the Enrollee in contacting a CBHP chosen
                  by the
                  Enrollee, unless the Enrollee
                  objects.

              

      

       

      
        	
              	•	
                If
                  a Enrollee obtains needed comprehensive services through a CBHP,
                  the
                  Contractor will be responsible for payment for laboratory services
                  in
                  connection with the comprehensive services provided by the CBHP.
                  The
                  Contractor shall not be liable for other Covered Services provided
                  by the
                  CBHP. The Contractor may require that laboratory services are provided
                  by
                  Providers that are Affiliated with
                  Contractor.

              

      

       

      (d)
        Services
        to Prevent Illness and Promote Health.
        The
        Contractor shall make documented efforts to provide initial health screenings
        and preventive care to all Enrollees. The Contractor shall provide, or arrange
        to provide, the following Covered Services to all Enrollees, as appropriate,
        to
        prevent illness and promote health:

       

      

       

      (1)
        EPSDT
        services in accordance with 89 111. Adm. Code 140.485 and described in this
        Article V, Section 5.12(a);

       

      

       

       

      
        
          
          

        

        
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      (2)
        Preventive Medicine Schedule which shall address preventive health care issues
        for Enrollees twenty-one (21) years of age or older (Article V, Section
        5.12(b));

       

      (3)
        Maternity care for pregnant Enrollees (Article V, Section 5.12(c));

       

      and

       

      (4)
        Family planning services and supplies, including physical examination and
        counseling provided during the visit, annual physical examination for family
        planning purposes, pregnancy testing, voluntary sterilization, insertion
        or
        injection of contraceptive drugs or devices, and related laboratory and
        diagnostic testing (except to the extent an Enrollee has chosen to obtain
        such
        services and supplies from a non-Affiliated Provider, in which case the
        Department shall be responsible for providing payment for such
        services).

       

      (e)
        Exclusions
        from Covered Services.
        In
        addition to those services and benefits excluded from Covered Services by
        89
        111. Adm. Code, Part 140, as amended from time to time, the following services
        and benefits shall NOT be included as Covered Services:

       

      (1)
        Dental services;

       

      (2)
        Mental health clinic services as provided through a community behavioral
        health
        provider as identified in 89 111. Adm. Code 140.452 and 140.454 and further
        defined in 59 111. Adm. Code, Part 132 "Medicaid Community Mental Health
        Services Program.";

       

      (3)
        Subacute alcoholism and substance abuse treatment services as provided through
        a
        community behavioral health provider as identified in 89 111. Adm. Code
        148.340(a) and further defined in 77 111. Adm. Code 2090;

       

      (4)
        Routine examinations to determine visual acuity and the refractive state
        of the
        eye, eyeglasses, other devices to correct vision, and any associated supplies
        and equipment. The Contractor shall refer Enrollees needing such services
        to
        Providers participating in the Medical Assistance Program able to provide
        such
        services, or to a central referral entity that maintains a list of such
        Providers;

       

      (5)
        Nursing facility services, or equivalent care provided at home because a
        skilled
        nursing facility is unavailable, beginning on the ninety-first (91st) day
        of
        service in a calendar year;

       

      (6)
        Services provided in an Intermediate Care Facility for the Mentally
        Retarded/Developmentally Disabled and services provided in a nursing facility
        to
        mentally retarded or developmentally disabled Participants;

       

      (7)
        Early
        intervention services, including case management, provided pursuant to the
        Early
        Intervention Services System Act (325 ILCS 20 et seq.);

       

      (8)
        Services provided through school-based clinics as such clinics are defined
        by
        the Department;

       

      

       

       

      
        
          
          

        

        
          
          

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      (9)
        Services provided through local education agencies that are enrolled with
        the
        Department under an approved individual education plan (IEP);

       

      (10)
        Services provided under Section 1915(c) home and community-based
        waivers;

       

      (11)
        Services funded through the Juvenile Rehabilitation Services Medicaid Matching
        Fund;

       

      (12)
        Services that are experimental and/or investigational in nature;

       

      (13)
        Services provided by a non-Affiliated Provider and not authorized by the
        Contractor, unless this Contract specifically requires that such services
        be
        covered;

       

      (14)
        Services that are provided without first obtaining a required referral or
        prior
        authorization as set forth in the Enrollee handbook;

       

      (15)
        Medical and/or surgical services provided solely for cosmetic
        purposes;

       

      (16)
        Diagnostic and/or therapeutic procedures related to infertility/sterility;
        and

       

      (17)
        Pharmacy services.

       

      (f)
        Limitations
        on Covered Services.
        The
        following services and benefits shall be limited as Covered
        Services:

       

      (1)
        Termination of pregnancy shall be provided only as allowed by applicable
        State
        and federal law (42 C.F.R. Part 441, Subpart E). In any such case, the
        requirements of such laws must be fully complied with and DPA Form 2390 must
        be
        completed and filed in the Enrollee's medical record. Termination of pregnancy
        shall not be provided to KidCare Enrollees.

       

      (2)
        Sterilization services may be provided only as allowed by State and federal
        law
        (see 42 C.F.R. Part 441, Subpart F). In any such case, the requirements of
        such
        laws must be fully complied with and a DPA Form 2189 must be completed and
        filed
        in the Enrollee's medical record.

       

      (3)
        If a
        hysterectomy is provided, a DPA Form 1977 must be completed and filed in
        the
        Enrollee's medical record.

       

      (g)
        Right
        of Conscience.
        The
        parties acknowledge that pursuant to 745 ILCS 70/1 et seq.,
        a
        Contractor may choose to exercise a right of conscience by not rendering
        certain
        Covered Services. Should the Contractor choose to
        exercise this right, the Contractor must promptly notify the Department of
        its
        intent to exercise its right of conscience in writing. Such notification
        shall
        contain the services that the Contractor is unable to render pursuant to
        the
        exercise of the right of conscience. The parties agree that at that time
        the
        Department shall adjust the Capitation payment to the Contractor and amend
        the
        contract accordingly.

       

       

      
        
          
          

        

        
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      Should
        the Contractor choose to exercise this right, the Contractor must notify
        Potential Enrollees, Prospective Enrollees and Enrollees that it has chosen
        to
        not render certain Covered Services, as follows:

       

      (1)
        To
        Potential Enrollees, prior to Enrollment;

       

      (2)
        To
        Prospective Enrollees, during Enrollment; and

       

      (3)
        To
        Enrollees, within ninety (90) days after adopting a policy with respect to
        any
        particular service that previously was a Covered Service.

       

      (h)
        Emergency
        Services.

       

      (1)
        The
        Contractor shall cover Emergency Services for all Enrollees whether the
        Emergency Services are provided by an Affiliated or non-Affiliated
        Provider.

       

      (2)
        The
        Contractor shall not impose any requirements for prior approval of Emergency
        Services. If an Enrollee calls the Contractor to request Emergency Services,
        such call shall receive an immediate response.

       

      (3)
        The
        Contractor shall cover Emergency Services for Enrollees who are temporarily
        away
        from their residence and outside the Contracting Area for all Emergency Services
        to which they would be entitled within the Contracting Area.

       

      (4)
        The
        Contractor shall have no obligation to cover medical services provided on
        an
        emergency basis that are not Covered Services under this Contract.

       

      (5)
        Elective care or care required as a result of circumstances that could
        reasonably have been foreseen prior to the Enrollee's departure from the
        Contracting Area are not covered. Unexpected hospitalization due to
        complications of pregnancy shall be covered. Routine delivery at term outside
        the Contracting Area, however, shall not be covered if the Enrollee is outside
        the Contracting Area against medical advice unless the Enrollee is outside
        of
        the Contracting Area due to circumstances beyond her control. The Contractor
        must educate the Enrollee of the medical and financial implications of leaving
        the Contracting Area and the importance of staying near the treating Provider
        throughout the last month of pregnancy.

       

      (6)
        The
        Contractor shall provide ongoing education to Enrollees regarding the
        appropriate use of Emergency Services.

       

      (7)
        The
        Contractor shall not condition coverage for Emergency Services on the treating
        Provider notifying the Contractor of the Enrollee's screening and treatment
        within ten (10) calendar days of presentation for Emergency
        Services.

       

      (8)
        The
        determination of whether or not an Enrollee is sufficiently Stabilized for
        discharge or transfer to another facility shall be binding on the
        Contractor.

       

      (i)
        Post-Stabilization
        Services.
        The
        Contractor shall cover Post-Stabilization Services provided by an Affiliated
        or
        non-Affiliated Provider in any the following situations: (a)

       

      

       

       

      
        
          
          

        

        
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      the
        Contractor authorized such services; (b) such services were administered
        to
        maintain the Enrollee's stabilized condition within one (1) hour of a request
        to
        the Contractor for authorization of further Post-Stabilization Services;
        or (c)
        the Contractor does not respond to a request to authorize further
        Post-Stabilization Services within one (1) hour, the Contractor could not
        be
        contacted, or the Contractor and the treating Provider cannot reach an agreement
        concerning the Enrollee's care and an Affiliated Provider is unavailable
        for a
        consultation, in which case the treating Provider must be permitted to continue
        the care of the Enrollee until an Affiliated Provider is reached and either
        concurs with the treating Provider's plan of care or assumes responsibility
        for
        the Enrollee's care.

       

      (j)
        Additional
        Services or Benefits.
        The
        Contractor shall obtain prior approval from the Department before offering
        any
        additional service or benefit not required under this Contract to all Enrollees.
        The Contractor shall notify Enrollees before discontinuing an additional
        service
        or benefit. The notice to Enrollees must be approved in advance by the
        Department. The Contractor shall continue any ongoing course of treatment
        for an
        Enrollee then receiving such service or benefit.

       

      (k)
        Telephone
        Access.
        The
        Contractor shall establish a toll-free twenty-four (24) hour telephone number
        to
        confirm eligibility for benefits and seek prior approval for treatment where
        required under the Plan, and shall assure twenty-four (24) hour access, via
        telephone(s), to medical professionals, either to the Plan directly or to
        the
        Primary Care Providers, for consultation to obtain medical care. The Contractor
        must also make a toll-free number available, at a minimum during the business
        hours of 9:00 a.m. until 5:00 p.m. on regular business days. This number
        also
        will be used to confirm eligibility for benefits, for approval for non-emergency
        services and for Enrollees to call to request Site, Primary Care Provider,
        or
        Women's Health Care Provider changes, to make complaints or grievances, to
        request disenrollment and to ask questions. The Contractor may use one toll-free
        number for these purposes or may establish two separate numbers.

       

      2.
        Any
        references in the contract to pharmacy services inconsistent with the changes
        in
        Article V, Section 5.1 for dates of service August 1, 2005 or later shall
        be
        read in a manner consistent with the changes in Article V, Section
        5.1.

       

      3.
        The
        following provision is added to the contract at Article VII, Section
        7.12:

       

      7.12
        Medical
        Loss Ratio Guarantee

       

      (a)
        For
        each calendar quarter that this contract is in effect, effective with the
        quarter beginning April 1, 2005, if the Contractor's Medical Loss Ratio (MLR)
        is
        less than 82%, the Department will recover by deduction from future payments
        a
        percentage of the quarter's premium revenue equal to the difference between
        the
        reported MLR and 82%.

       

      (b)
        Medical Loss Ratio shall be calculated by dividing total hospital and medical
        expenses incurred in Illinois by premium revenue paid by the Department.
        Premium
        revenue for a quarter shall be the premium revenue accrued, including Hospital
        Delivery Case Rate Payments. Expenses reported as Incurred But Not Reported
        (IBNR) shall be subject to review by the Department for actuarial soundness.
        All
        elements of reports used to calculate MLR are subject to audit by the
        Department. Audits may be ordered by the Department within

       

      

       

      

       

       

      
        
          
          

        

        
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      30
        days
        of Departmental receipt of each quarterly report, and audits shall encompass
        the
        total subject matter of that report.

       

      (c)
        Hospital and medical expenses are the incurred costs of providing direct
        care to
        Enrollees for Covered Services. Outreach and general education are not included
        in medical expenses.

       

      (d)
        At
        the end of the four quarters ending March 31, 2006, the Department will review
        the Contractor's MLR for the full four quarters and recover or reconcile
        previous recoveries so that the Department has recovered the percentage of
        the
        total premium revenue for the four quarters equal to the difference between
        the
        cumulative MLR below 82% and 82%. Reconciliation shall consist of payment
        by the
        Contractor of any difference below the annualized 82% MLR not previously
        deducted, or repayment to the Contractor of deductions over the annualized
        82%
        MLR previously made by the Department. A similar reconciliation will be
        performed at the end of each four quarters or the termination of any contractual
        relationship between the parties. Notwithstanding the provisions of section
        7.12(b), the Department may order an audit of the reporting for the full
        four
        quarters within 45 days of Departmental receipt of a cumulative report of
        the
        four quarters.

       

      (e)
        The
        Contractor shall report all information necessary to effectuate this section
        in
        a format and on a schedule consistent with NAIC guidelines. The Department
        may
        request additional supporting information necessary to effectuate this section,
        and the Contractor shall report this information to the Department in a timely
        manner.

       

      (f)
        For
        purposes of calculating the Contractor's MLR, for the quarter beginning April
        1,
        2005, and for the month of July 2005, premium revenue will be adjusted to
        remove
        premium revenue for pharmacy services in excess of Contractor's costs for
        pharmacy services.

       

      4.
        First
        Amended Attachment I shall be deleted and replaced by the attached
        Second

      Amended
        Attachment I. Each
        reference to Attachment I or First Amended Attachment I in the Contract shall
        be
        replaced with a reference to Second Amended Attachment I.

       

      All
        other
        terms and conditions of the CONTRACT shall remain in full force and
        effect.

       

       

      
        
          
          

        

        
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      IN
        WITNESS WHEREOF,
        the
        parties have hereunto caused this agreement to amend the CONTRACT to be executed
        by their duly authorized representatives, effective August 1, 2005.

      
 

      
        
          	
                      DEPARTMENT
                    OF
                    HEALTHCARE & FAMILY SERVICES

                   

                      By:
                    /s/
                    Barry S. Maram

                  Barry
                    S. Maram

                   

                       Title:
Director

                       Date:7/29/05

                	
                  HARMONY
                    HEALTH PLAN OF ILLINOIS, INC.

                  By:
                    /s/ Todd S. Farha

                   

                   

                  Printed
                    Name: Todd
                    S. Farha

                  Title:
                    President
                    and CEO

                  Date:
                    7/27/05

                  Fein:
                    36-4050495

                

        

       

       

       

       

      

      
        
          
          

        

        
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            10

          
          

        

        
          
          

        

      

      SECOND
        AMENDED ATTACHMENT I RATE SHEETS

       

      (a)
        Contractor Name: Harmony Health Plan of Illinois, me.

       

      Address:
        125 South Wacker Drive, Suite 2600 

       

      Chicago,
        IL 60606

       

      (b)
        Contracting Area(s) Covered by the Contractor and Enrollment Limit:

       

      
        	
                 

                Contracting
                  Area

              	
                 

                Enrollment
                  Limit

              
	
                 

                The
                  following counties in Region III: 

                 

                Franklin
                  (effective 03/15/04 through 8/31/05) Jackson (effective 09/01/03
                  through
                  8/31/05) Madison Perry (effective 09/01/03) 

                 

                Randolph
                  (effective 09/01/03) 

                 

                St.
                  Clair Washington (effective 09/01/03) Williamson (effective 09/01/03
                  through 8/31/05)

              	
                 

                50,000

              
	
                 

                Region
                  IV

              	
                 

                100,000

              

      

       

      (c)
        Total
        Enrollment Limit for all Contracting Areas: 150,000

       

      (d)
        Threshold Review Levels: Counties listed above in Region III:     40,000 

                       Region
        IV                  80,000

      (e)
        Standard Capitation Rates for Enrollees, effective
        August 1,2003
        through
        July 31,2005:

       

      
        	
                 

                Age/Gender
                  Mo = month Yr == year

              	
                 

                Region
                  I (N.W. Illinois) PMPM

              	
                 

                Region
                  II (Central Illinois) PMPM

              	
                 

                Region
                  III (Southern Illinois) PMPM

              	
                 

                Region
                  IV (Cook County) PMPM

              	
                 

                Region
                  V (Collar Counties) PMPM

              
	
                 

                0-3Mo

              	
                 

                $1,152.25

              	
                 

                $1,178.77

              	
                 

                $1,242.71

              	
                 

                $1,244.64

              	
                 

                $854.58

              
	
                 

                4Mo-lYr

              	
                 

                127.81

              	
                 

                117.63

              	
                 

                165.94

              	
                 

                125.04

              	
                 

                108.35

              
	
                 

                2Yr-5Yr

              	
                 

                63.77

              	
                 

                67.81

              	
                 

                71.74

              	
                 

                58.67

              	
                 

                56.28

              
	
                 

                6Yr-13Yr

              	
                 

                72.08

              	
                 

                79.78

              	
                 

                75.18

              	
                 

                58.18

              	
                 

                57.47

              
	
                 

                14Yr-20Yr,
                  Male

              	
                 

                115.93

              	
                 

                135.96

              	
                 

                131.18

              	
                 

                90.67

              	
                 

                142.60

              
	
                 

                14Yr-20Y,
                  Female

              	
                 

                148.51

              	
                 

                157.40

              	
                 

                155.15

              	
                 

                112.48

              	
                 

                119.82

              
	
                 

                21Yr-44Yr,
                  Male

              	
                 

                161.79

              	
                 

                216.53

              	
                 

                201.90

              	
                 

                164.23

              	
                 

                159.43

              
	
                 

                21Yr-44Yr,
                  Female

              	
                 

                217.61

              	
                 

                228.14

              	
                 

                237.13

              	
                 

                185.81

              	
                 

                184.20

              
	
                 

                45Yr+
                  Male and Female

              	
                 

                437.86

              	
                 

                486.40

              	
                 

                476.29

              	
                 

                359.61

              	
                 

                409.17

              

      

       

       

      
        
          
          

        

        
          Att.
            I -1

          
          

        

        
          
          

        

      

       

      Standard
        Capitation Rates for Enrollees, effective
        August 1, 2005
        through
        July 31, 2006:

      
        	
                 

                Age/Gender
                  Mo = month Yr = year

              	
                 

                Region
                  I

                 

                (N.W.
                  Illinois) PMPM

              	
                 

                Region
                  II (Central Illinois) PMPM

              	
                 

                Region
                  III (Southern Illinois) PMPM

              	
                 

                Region
                  IV (Cook County) PMPM

              	
                 

                Region
                  V (Collar Counties) PMPM

              
	
                 

                0-3Mo

              	
                 

                $1,342.61

              	
                 

                $1,178.83

              	
                 

                $1,271.32

              	
                 

                $1,369.28

              	
                 

                $948.46

              
	
                 

                4Mo-lYr

              	
                 

                121.62

              	
                 

                109.83

              	
                 

                154.41

              	
                 

                117.41

              	
                 

                99.27

              
	
                 

                2Yr-5Yr

              	
                 

                53.51

              	
                 

                57.02

              	
                 

                59.41

              	
                 

                51.49

              	
                 

                49.60

              
	
                 

                6Yr-13Yr

              	
                 

                49.37

              	
                 

                51.29

              	
                 

                52.22

              	
                 

                45.53

              	
                 

                42.00

              
	
                 

                14Yr-20Yr,
                  Male

              	
                 

                85.90

              	
                 

                92.02

              	
                 

                85.37

              	
                 

                70.16

              	
                 

                100.73

              
	
                 

                14Yr-20Y,
                  Female

              	
                 

                127.53

              	
                 

                128.58

              	
                 

                123.97

              	
                 

                94.84

              	
                 

                98.76

              
	
                 

                21Yr-44Yr,Male

              	
                 

                113.28

              	
                 

                161.06

              	
                 

                139.13

              	
                 

                121.91

              	
                 

                110.33

              
	
                 

                21Yr-44Yr,
                  Female

              	
                 

                164.91

              	
                 

                167,03

              	
                 

                168.42

              	
                 

                148.97

              	
                 

                141.81

              
	
                 

                45Yr+
                  Male and Female

              	
                 

                277.48

              	
                 

                310.00

              	
                 

                275.75

              	
                 

                258.08

              	
                 

                273.13

              

      

       

      (f) Hospital
        Delivery Case Rate, effective August 1, 2003 through July 31, 2005:

       

      
        	
                 

                Hospital
                  Delivery Case Rate

                 

                (per
                  delivery)

              	
                 

                $3,196.12

              	
                 

                $3,104.66

              	
                 

                $3,281.22

              	
                 

                $3,748.33

              	
                 

                $3,276.03

              

      

       

      Hospital
        Delivery Case Rate, effective
        August 1, 2005
        through
        July 31,2006:

       

      
        	
                 

                Hospital
                  Delivery Case Rate (per delivery)

              	
                 

                $3,008.88

              	
                 

                $2,900.77

              	
                 

                $3,100.59

              	
                 

                $3,431.08

              	
                 

                $3,113.07

              

      

       

      Alt.
        I -
        2Exhibit 10.2

    

      Exhibit
        10.2

      Medicaid
        HMO Contract

      AHCA
        CONTRACT NO. FA522 AMENDMENT NO. 10

       

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

       

      1. Standard
        Contract, Section II.A, Contract Amount, the first sentence is hereby amended
        to

      now
        read:

       

      To
        pay
        for contracted services according to the conditions of Attachment I in an
        amount
        not to exceed
        $665,594,194.00
        (an
        increase of $1,836,972.00), subject to availability of funds.

       

      2. Attachment
        I, Section 10.5, Optional Services, is hereby deleted in its entirety and
        replaced with the following:

       

      10.5 Optional
        Services

       

      The
        Plan
        shall offer the following services within all applicable Medicaid
        guidelines:

      
        	 	
                 

                Covered

              	
                 

                Not
                  Covered

              
	
                 

                Dental
                  Services

              	
                 

                ____________

              	
                 

                ___________

              
	
                 

                Transportation
                  Services

              	
                 

                _______X___

              	
                 

                ___________

              
	
                 

                Frail/Elderly
                  Program (in
                  accordance with Exhibit 110.4 of this contract)

              	
                 

                ____________

              	
                 

                _________

              

      

      

       

      3. Attachment
        I, Section 10.8.14, Transportation Services (optional), is hereby deleted
        in its
        entirety and replaced with the following:

       

      10.8.14 Transportation
        Services (optional)

       

      
        	a.	
                Transportation
                  Services are the arrangement and provision of an appropriate mode
                  of
                  transportation for Enrollees to receive medical care services.
                  The Plan
                  shall comply with the limitations and exclusions in the Medicaid
                  Transportation Coverage, Limitations & Reimbursement Handbook (the
                  "Transportation Handbook") except where compliance conflicts with
                  the
                  terms of this Contract. In no instance may the limitations or exclusions
                  imposed by the Plan be more stringent than those specified in the
                  Transportation Handbook. The Plan
                  shall

              

      

       

      AHCA
        Contract No. FA522, Amendment No. 10, Page 1 of 29

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

       

      Medicaid
        HMO Contract

       

      offer
        Transportation Services free of charge and shall not charge Enrollees a co-pay
        for use of the Transportation Services. In providing Transportation Services,
        the Plan:

       

       1. Shall
        assure that providers of transportation are appropriately licensed and insured
        in accordance with the provisions of the Transportation Handbook;

       

      2. Must
        provide Transportation Services for all Enrollees seeking necessary Medicaid
        services;

       

      3. Shall
        be
        responsible for the cost of transporting an Enrollee from a nonparticipating
        facility or hospital to a Participating Facility or Hospital if the reason
        for
        transport is solely for the Plan's convenience, regardless of whether the
        Plan
        covers Medicaid Transportation Services; and

       

      4. Shall
        pay
        Transportation Services providers in accordance with the requirements set
        forth
        in this Contract.

       

      b. The
        Plan
        may delegate the provision of Transportation Services to a third
        party.

       

      1. The
        Plan
        shall provide a copy of the model Participating Transportation Subcontract
        to
        the Bureau of Managed Health Care in compliance with Section 70.0 of the
        Contract.

       

      2. The
        Plan
        may subcontract with more than one Transportation Services
        provider.

       

      3. The
        Plan
        shall maintain oversight of any third party providing Transportation Services
        on
        the Plan's behalf.

       

      c. The
        Plan
        shall provide the following non-emergency transportation, at a minimum, as
        part
        of its line of Transportation Services:1

       

      1. Ambulatory
        transportation;

       

      2. Long
        haul
        ambulatory transportation;

       

      3. Wheelchair
        transportation;

       

      4. Stretcher
        transportation;

       

      5. Multiload
        transportation;

       

      6. Mass
        transit transportation;

      _________________________

      '
        As
        defined in the Transportation Handbook.

       

      AHCA
        Contract No. FA522, Amendment No. 10, Page 2 of 29

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      Medicaid
        HMO Contract

       

      7. Over-the-road
        bus;

       

      8. Over-the-road
        train;

       

      9. Private
        volunteer transportation;

       

      10. Escort
        services (including medical escort); and

       

      11. Commercial
        air carrier transportation.

       

      d. The
        Plan
        shall provide the following encounter data on a quarterly basis:

       

      1.  A
        call
        log broken down by month that includes the following information:

       

      (a) Number
        of
        calls received;

       

      (b) Average
        time required to answer a
        call;

       

      (c) Number
        of
        abandoned calls;

       

      (d) Percentage
        of calls that are abandoned;

       

      (e) Average
        abandonment time; and

       

      (f) Average
        call time.

       

      2. A
        listing
        of the total number of reservations of Transportation Services by month,
        level
        of service and percentage of level of service utilized, to include, but not
        be
        limited to, the following:

       

      (a) Ambulatory
        transportation;

       

      (b) Long
        haul
        ambulatory transportation;

       

      (c) Wheelchair
        transportation;

       

      (d) Stretcher
        transportation;

       

      (e) Ambulatory
        multiload transportation;

       

      (f) Wheelchair
        multiload transportation;

       

      (g) Mass
        transit pending transportation;

       

      (h) Mass
        transit transportation;

       

      AHCA
        Contract No. FA522, Amendment No. 10, Page 3 of 29

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

       

      Medicaid
        HMO Contract

       

      (i) Mass
        transit transportation (Enrollee has pass); and 

       

      (j) Mass
        transit transportation (sent pass to Enrollee).

       

      3. A
        listing
        of the total number of authorized uses of Transportation Services, by month,
        level of service and percentage of level of service utilized, to include,
        but
        not be limited to, the following:

       

      (a) Ambulatory
        transportation;

       

      (b) Long
        haul
        ambulatory transportation;

       

      (c) Wheelchair
        transportation;

       

      (d) Stretcher
        transportation;

       

      (e) Ambulatory
        multiload transportation;

       

      (f) Wheelchair
        multiload transportation;

       

      (g) Mass
        transit pending transportation;

       

      (h) Mass
        transit transportation;

       

      (i) Mass
        transit transportation (Enrollee has pass); and 

       

      (j) Mass
        transit transportation (sent pass to Enrollee).

       

      4. A
        listing
        of the total number of canceled trips, by month, level of service and percentage
        of level of service utilized, to include, but not be limited to, the
        following:

       

      (a) Ambulatory
        transportation;

       

      (b) Long
        haul
        ambulatory transportation;

       

      (c) Wheelchair
        transportation;

       

      (d) Stretcher
        transportation;

       

      (e) Ambulatory
        multiload transportation;

       

      (f) Wheelchair
        multiload transportation;

       

      (g) Mass
        transit pending transportation;

       

      AHCA
        Contract No. FA522, Amendment No. 10, Page 4 of 29

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      Medicaid
        HMO Contract

       

      (h) Mass
        transit transportation;

       

      (i) Mass
        transit transportation (Enrollee has pass); and 

       

      (j) Mass
        transit transportation (sent pass to Enrollee).

       

      5. A
        listing
        of the total number of denied Transportation Services, by month, and a detailed
        description of why the Plan denied the Transportation Service
        request.

       

      6. A
        listing
        of the total number of authorized trips, by facility type, for each month
        and
        level of service.

       

      7. A
        listing
        of the total number of Transportation Service claims and payments, by facility
        type, for each month and level of service.

       

      e. Before
        providing Transportation Services, the Plan shall provide to the Bureau of
        Managed Health Care a copy of its policies and procedures relating to the
        following:

       

      1. How
        the
        Plan will determine eligibility for each Enrollee;

       

      2. The
        Plan's course of action as to how it will determine what type of transportation
        to provide to a particular Enrollee;

       

      3. The
        Plan's procedure for providing prior authorization to Enrollees requesting
        Transportation Services;

       

      4. The
        Plan's comprehensive employee training program to investigate potential
        fraud;

       

      5. How
        the
        Plan will review Participating Transportation Providers who demonstrate a
        pattern or practice of:

       

      (a)  Falsified
        encounter or service reports;

       

      (b) Overstated
        reports or up-coded levels of service; and/or

       

      (c) Fraud
        or
        abuse.2

       

      6. How
        the
        Plan will review Participating Transportation Providers that:

       

      (a) Alter,
        falsify or destroy records prior to the end of the five (5) year records
        retention benchmark;

      

      ____________________________

      2
        As
        defined in section 409.913, F.S., 2004.

       

      AHCA
        Contract No. FA522, Amendment No. 10, Page 5 of 29

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

       

      Medicaid
        HMO Contract

       

      (b) Make
        false statements about credentials;

       

      (c) Misrepresent
        medical information to justify referrals;

       

      (d) Failed
        to
        provide scheduled transportation for Enrollees;

       

      (e) Charge
        Enrollees for covered services; and/or

       

      (f) Have
        committed, or been suspected of committing, fraud or abuse.1 

       

      
        	 	
                7.

              	
                How
                  the Plan will provide Transportation Services outside of the Plan's
                  service area.

              

      

       

      (a) The
        Plan
        shall state clearly the guidelines it will use in order to control costs
        when
        providing Transportation Services outside of the Plan's service
        area.

       

      f. The
        Plan
        shall report immediately, in writing to the Agency Contract Manager and the
        Medicaid Program Integrity Unit, any aspect of Transportation Service delivery,
        by any Transportation Services Provider, any adverse or untoward
        incident.4
        The Plan
        shall also report, immediately upon identification, in writing to the Agency
        Contract Manager and the Medicaid Program Integrity Unit, all instances of
        suspected Enrollee or Transportation Services Provider fraud or
        abuse.5

       

      1. The
        Plan
        shall file a written report with the Medicaid Program Integrity Unit and
        the
        Agency Contract Manager immediately upon the detection of a potentially or
        suspected fraudulent or abusive action by a Transportation Services Provider.
        At
        a minimum, the report must contain the name, tax identification number and
        contract information of the Transportation Services Provider and a description
        of the suspected fraudulent or abusive act. The report shall be in the form
        of a
        narrative.

       

      g. Insurance,
        Safety Requirements
        and
        Standards6

       

      1. The
        Plan
        shall ensure compliance with the minimum liability insurance requirement
        of
        $100,000 per person and $200,000 per incident for all transportation services
        purchased or provided for the transportation disadvantaged through the Plan/
        The
        Plan shall indemnify and hold harmless the local, State, and federal governments
        and their entities and

      

      _________________________

      3As
        defined in section 409.913, F.S., 2004.

      4
        See
        section 641.55, F.S., 2004.

      5
        As
        defined in section 409.913, F.S., 2004.

      '
        Including, but not limited to, 41-2, F.A.C., 2004.

      7
        See
        section 768.28(5), F.S., 2004.

       

      AHCA
        Contract No. FA522, Amendment No. 10, Page 6 of 29

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      Medicaid
        HMO Contract

       

      the
        Agency from any liabilities arising out of or due to an accident or negligence
        on the part of the Plan and/or all Participating Transportation Providers
        under
        contract to the Plan. The Plan may act as a Participating Transportation
        Provider, in which case it must follow all requirements set forth below for
        Participating Transportation Providers.

       

      2. The
        Plan,
        and all Participating Transportation Providers, shall ensure that all operations
        and services are in compliance with all federal and State safety
        requirements.8

       

      3. The
        Plan,
        and all Participating Transportation Providers, shall ensure continuing
        compliance with all applicable State or federal laws relating to drug
        testing.9

       

      4. The
        Plan
        and all Participating Transportation Providers shall adhere to the following
        standards, including, but not limited to, the following:

       

      (a) Drug
        and
        alcohol testing for safety sensitive job positions relating to the provision
        of
        Transportation Services regarding pre-employment, randomization, post-accident,
        and reasonable suspicion as required by the Federal Highway Administration
        and
        the Federal Transit Administration;

       

      (b) Use
        of
        child safety restraint devices, where the use of such devices would not
        interfere with the safety of a child (for example, a child in a
        wheelchair);

       

      (c) Enrollee
        property that can be carried by the passenger and/or driver, and can be stowed
        safely on the vehicle, shall be transported with the passenger at no additional
        charge. The driver shall provide transportation of the following items, as
        applicable, within the capabilities of the vehicle:

       

      (1) Wheelchairs;

       

      (2) Child
        seats;

       

      (3) Stretchers;

       

      (4) Secured
        oxygen;

       

      (5) Personal
        assistive devices; and/or

       

      (6) Intravenous
        devices.

      

      ____________________________

      8
        Including, but not limited to, section 341.061(2)(a), Florida Statutes, and
        Chapter 14-90, F.A.C.

      9
        Including, but not limited to, to section 112.0455, Florida Statutes, 2004,
        Chapters 59A-24,41 U.S.C. 701, and 49 C.F.R., Parts 29 and 382.

       

      

       

      AHCA
        Contract No. FA522, Amendment No. 10, Page 7 of 29

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      Medicaid
        HMO Contract

       

      (d) Vehicle
        transfer points shall provide shelter, security, and safety of
        Enrollees;

       

      (e) Maintain
        inside all vehicles copies of the Plan's toll free phone number for Enrollee
        complaints;

       

      (f) The
        interior of all vehicles shall be free from dirt, grime, oil, trash, torn
        upholstery, damaged or broken seats, protruding metal or other objects or
        materials which could soil items placed in the vehicle or provide discomfort
        for
        Enrollees;

       

      (g) Maintain
        a passenger/trip database for each Enrollee transported by the
        Plan/Participating Transportation Provider;

       

      (h) Ensure
        adequate seating for paratransit services for each Enrollee and escort, child,
        or personal care attendant, and shall ensure that the vehicle does not transport
        more passengers than the registered passenger seating capacity in a vehicle
        at
        any time;

       

      (i) Ensure
        adequate seating space for transit services for each Enrollee and escort,
        child,
        or personal care attendant, and shall ensure that transit vehicles provide
        adequate seating or standing space to each rider, and shall ensure that the
        vehicle does not transport more passengers than the registered passenger
        seating
        or standing capacity in a vehicle at any time;

       

      (j) Drivers
        for paratransit services shall identify themselves by name and company in
        a
        manner that is conducive to communications with the specific passenger, upon
        pickup of each Enrollee, group of Enrollees, or representative, guardian,
        or
        associate of the Enrollee, except in situations where the driver regularly
        transports the Enrollee on a recurring basis;

       

      (k) Each
        driver must have photo identification that is viewable by the passenger.
        Name
        patches, inscriptions or badges that affix to driver clothing are acceptable.
        For transit services, the driver photo identification shall be in a conspicuous
        location in the vehicle;

       

      (1) The
        paratransit driver shall provide the Enrollee with boarding assistance, if
        necessary or requested, to the seating portion of the vehicle. The boarding
        assistance shall include, but not be limited to, opening the vehicle door,
        fastening the seat belt or utilization of wheel chair securement devices,
        storage of mobility assistive devices and closing the vehicle door. In the
        door-through-door

       

      AHCA
        Contract No. FA522, Amendment No. 10, Page 8 of 29

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      Medicaid
        HMO Contract

       

      paratransit
        service category, the driver shall open and close doors to buildings, except
        in
        situations in which assistance in opening and/or closing building doors would
        not be safe for passengers remaining on the vehicle. The driver shall provide
        assisted access in a dignified manner. Drivers may not assist wheelchair
        passengers up or down more than one (1) step, unless it can be performed
        safely
        as determined by the Enrollee, guardian, and driver;

       

      
        	 	
                (m)

              	
                Smoking,
                  eating and drinking are prohibited in any vehicle, except in cases
                  in
                  which, as a Medical Necessity, the Enrollee requires fluids or
                  sustenance
                  during transport;

              

      

       

      (n) Ensure
        that all vehicles are equipped with two-way communications, in good working
        order and audible to the driver at all times, by which to communicate with
        the
        Transportation Services hub or base of operations;

       

      (o) Ensure
        that all vehicles have working air conditioners and heaters. The Plan shall
        ensure that all vehicles that do not have a working air conditioner or heater
        are removed from the vehicle pool and scheduled for repair or
        replacement;

       

      (p) Develop
        and implement a first aid policy and cardiopulmonary resuscitation
        policy;

       

      (q) Ensure
        that all drivers providing Transportation Services undergo a background
        screening;

       

      (r) Establish
        Enrollee pick-up windows and communicate these windows to Participating
        Transportation Providers and Enrollees;

       

      (s) Establish
        a minimum 24-hour advanced notification policy to obtain Transportation
        Services. The Plan shall communicate said policy to Participating Transportation
        Providers and Enrollees;

       

      (t) Establish
        a performance measure to evaluate the safety of the Transportation Services
        provided by Participating Transportation Providers. The Plan shall report
        the
        results of the evaluation to the Agency on August 151
        of each
        year;

       

      (u) Establish
        a performance measure to evaluate the reliability of the vehicles utilized
        by
        Participating Transportation Providers. The Plan shall report the results
        of the
        evaluation to the Agency on August 15th
        of each
        year; and

       

      AHCA
        Contract No. FA522, Amendment No. 10, Page 9 of 29

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      Medicaid
        HMO Contract

       

      (v) Establish
        a performance measure to evaluate the quality of service provided by a
        Participating Transportation Provider. The Plan shall report the results
        of the
        evaluation to the Agency on August 15th
        of each
        year.

       

      h. Operational
        Standards10
        - Each
        Plan shall implement, or ensure that each Participating Transportation Provider
        has implemented, policies and procedures that, at a minimum, comply with
        the
        following:

       

      1. Address
        the following safety elements and requirements:

       

      (a) Safety
        policies and responsibilities;

       

      (b) Vehicle
        and equipment standards and procurement criteria;

       

      (c) Operational
        standards and procedures;

       

      (d) Vehicle
        driver and employee selection;

       

      (e) Driving
        requirements;

       

      (f) Vehicle
        driver and employee training;

       

      (g) Vehicle
        maintenance;

       

      (h) Investigations
        of events described under Section 10.8.14.h.7, Transportation Services,
        below;

       

      (i) Hazard
        identification and resolution;

       

      (j) Equipment
        for transporting wheelchairs;

       

      (k) Safety
        data acquisition and analysis;

       

      (1) Safety
        standards for private contract vehicle transit system(s) that provide(s)
        transportation services for compensation as a result of a contractual agreement
        with the vehicle transit system.

       

      2. Shall
        submit an annual safety certification to the Agency verifying the
        following:

       

      
        	 	
                (a)

              	
                Adoption
                  of policies and procedures that, at a minimum, establish standard
                  set
                  forth in this Section; and

              

      

      

      

      

      

      

      

      

      

      ___________________________

      3
        For
        reference, see 14-90, F.A.C., 2004.

       

      AHCA
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                (b)

              	
                The
                  Plan/Participating Transportation Provider is in full compliance
                  with the
                  policies and procedures relating to Transportation Services, and
                  that it
                  has performed annual safety inspections on all vehicles operated
                  by the
                  Plan/Participating Transportation Provider, by persons meeting
                  the
                  requirements set forth in Section 10.8.14.h.6,
                  below.

              

      

       

      3. The
        Plan
        shall suspend immediately a Participating Transportation Provider if, at
        any
        time, continued use of that Participating Transportation Provider, is unsafe
        for
        passenger service or poses a potential danger to public safety.

       

      4. Address
        the following security requirements:

       

      (a) Security
        policies, goals, and objectives;

       

      (b) Organization,
        roles, and responsibilities;

       

      (c) Emergency
        management processes and procedures for mitigation, preparedness, response,
        and
        recovery;

       

      (d) Procedures
        for investigation of any event involving a vehicle, or taking place on vehicle
        transit system controlled property, resulting in a fatality, injury, or property
        damage as discussed in Section 10.8.14.h.7, below;

       

      (e) Procedures
        for the establishment of interfaces with emergency response
        organizations;

       

      (f) Employee
        security and threat awareness training programs;

       

      (g) Conduct
        and participate in emergency preparedness drills and exercises; and

       

      (h) Security
        requirements for Participating Transportation Providers that provide
        Transportation Services for compensation as a result of a contractual agreement
        with the Plan/Participating Transportation Provider.

       

      
        	 	
                5.

              	
                Shall
                  establish criteria and procedures for selection, qualification,
                  and
                  training of all drivers. The criteria shall include, at a minimum,
                  the
                  following:

              

      

       

      (a) Driver
        qualifications and background checks with minimum hiring

      standards;

       

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      (b) Driving
        and criminal background checks for all new drivers;

       

      (c) Verification
        and documentation of valid driver licenses for all employees who drive
        vehicles;

       

      (d) Training
        and testing to demonstrate and ensure adequate skills and capabilities to
        safely
        operate each type of vehicle or vehicle combination before driving
        unsupervised;

       

      (e) At
        a
        minimum, drivers shall be given explicit instructional and procedural training
        and testing in the following areas:

       

      (1) Plans/Participating
        Transportation Provider safety and operational policies and
        procedures;

       

      (2) Operational
        vehicle and equipment inspections;

       

      (3) Vehicle
        equipment familiarization;

       

      (4) Basic
        operations and maneuvering;

       

      (5) Boarding
        and alighting passengers;

       

      (6) Operation
        of wheelchair lift and other special equipment

      and
        driving conditions;

       

      (7) Defensive
        driving;

       

      (8) Passenger
        assistance and securement;

       

      (9) Handling
        of emergencies and security threats; and (10) Security and threat
        awareness.

       

      (f) Shall
        provide written operational and safety procedures to all vehicle drivers
        before
        the drivers are allowed to drive unsupervised. These procedures and instructions
        shall address, at a minimum, the following:

       

      (1) Communication
        and handling of unsafe conditions, security threats, and
        emergencies;

       

      (2) Familiarization
        and operation of safety and emergency equipment, wheelchair lift equipment,
        and
        restraining devices;

      and

       

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      (3)
        Application and compliance with applicable federal and State rules and
        regulations.''

       

      (g) Shall
        maintain the following records for at least five (5) years:

       

      (1) Records
        of vehicle driver background checks and qualifications;

       

      (2) Detailed
        descriptions of training administered and completed by each vehicle
        driver;

       

      (3) A
        record
        of each vehicle driver's duty status, which shall include total days worked,
        on-duty hours, driving hours and time of reporting on- and off-duty each
        day;
        and

       

      (4) Any
        documents required to be prepared by this Contract.

       

      (h) Shall
        establish a drug-free workplace policy statement12
        and a
        substance abuse management and testing program;13
        and

       

      (i) Shall
        require that drivers write and submit a daily vehicle

      inspection
        report.14

       

      
        	 	
                6.

              	
                Shall
                  establish a maintenance policy and procedures for preventative
                  and routine
                  maintenance for all vehicles. The maintenance policy and procedures
                  shall
                  ensure, at a minimum, that:

              

      

       

      (a) All
        vehicles, all parts and accessories on such vehicles, and any additional
        parts
        and accessories which may affect the safety of vehicle operation, including
        frame and frame assemblies, suspension systems, axles and attaching parts,
        wheels and rims, and steering systems, are regularly and systematically
        inspected, maintained and lubricated in accordance with the standards developed
        and established according to the vehicle manufacturer's recommendations and
        requirements;

       

      (b) That
        a
        recording and tracking system is established for the types of inspections,
        maintenance, and lubrication intervals, including the date or mileage when
        these
        services are due. Required maintenance inspections shall be more comprehensive
        than daily inspections performed by the driver;

       

      

      ____________________________

      "
        The
        provisions in Sections 10.8.14.h.5(e) and (f), above, shall not apply to
        personnel licensed and authorized by the Plan/Participating Transportation
        Provider to drive, move, or road test a vehicle in order to perform repairs
        or
        maintenance services where it has been determined that such temporary operation
        does not create an unsafe operating condition or create a hazard to public
        safety.

      12
        In
        accordance with 49 C.F.R. Part 29.

      13
        In
        accordance with 49 C.F.R. Parts 40 and 655, October 1,2004.

      14
        Pursuant
        to Rule 14-90.006, F.A.C.

       

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      (c) That
        proper preventive maintenance is performed when on all

      vehicles;
        and

       

      (d) That
        the
        Plan/Participating Transportation Provider maintain and provide written
        documentation of preventive maintenance, regular maintenance, inspections,
        lubrication, and repairs performed for each vehicle under their control.
        Such
        records shall be maintained by the Plan/Participating Transportation Provider
        for at least five (5) years and include, at a minimum, the following
        information:

       

      (1) Identification
        of the vehicle, including make, model, and license number or other means
        of
        positive identification and ownership;

       

      (2) Date,
        mileage, and type of inspection, maintenance, lubrication, or repair
        performed;

       

      (3) Date,
        mileage, and description of each inspection, maintenance, and lubrication
        intervals performed;

       

      (4) If
        not
        owned by the Plan/Participating Transportation Provider, the name of any
        person
        or lessor furnishing any vehicle; and

       

      (5) The
        name
        and address of any entity or contractor performing an inspection, maintenance,
        lubrication, or repair.

       

      
        	 	
                7.

              	
                The
                  Plan/Participating Transportation Provider shall investigate, or
                  cause to
                  be investigated, any event involving a vehicle or taking place
                  on
                  Plan/Participating Transportation Provider controlled property
                  resulting
                  in a fatality, injury, or property damage as
                  follows:

              

      

       

      
        	 	
                (a)

              	
                A
                  fatality, where an individual is confirmed dead, within three (3)
                  days of
                  a Transportation Services related event, excluding suicides and
                  deaths
                  from illnesses. The Plan must file detailed report of the incident
                  with
                  the Agency within ten (10) days of the event;15

              

      

       

      
        	 	
                (b)

              	
                Injuries
                  requiring immediate medical attention away from the scene for two
                  (2) or
                  more individuals;

              

      

       

      
        	 	
                (c)

              	
                Property
                  damage to Plan/Participating Transportation Provider vehicles,
                  other
                  Plan/Participating Transportation Provider property or facilities,
                  or any
                  other property, except the
                  Plan/Participating

              

      

       

      15
        See
        section 641.55(6), F.S., 2004.

       

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      Transportation
        Provider shall have the discretion to investigate events resulting in property
        damage totaling less than $1,000;

       

      
        	 	
                (d)

              	
                Evacuation
                  of a vehicle due where there is imminent danger to passengers on
                  the
                  vehicle, excluding evacuations due to vehicle operation
                  issues;

              

      

       

      (e) Each
        investigation shall be documented in a final report that includes a description
        of investigation activities, identified causal factors and a corrective action
        plan;

       

      (1) Each
        corrective action plan shall identify the action to be taken by the
        Plan/Participating Transportation Provider and the schedule for its
        implementation; and

       

      (2) The
        Plan/Participating Transportation Provider must monitor and track the
        implementation of each corrective action plan.

       

      (f) The
        Plan/Participating Transportation Provider shall maintain all investigation
        reports, corrective action plans, and related supporting documentation for
        a
        minimum of five (5) years from the date of completion of the
        investigation.

       

      i. Medical
        Examinations for Drivers - The Plan/Participating Transportation Provider
        shall
        establish medical examination requirements for all applicants for driver
        positions and for existing drivers. The medical examination requirements
        shall
        include a pre-employment examination for applicants, an examination at least
        once every two (2) years for existing drivers, and a return to duty examination
        for any driver prior to returning to duty after having been off duty for
        thirty
        (30) or more days due to an illness, medical condition, or injury.

       

      1. Medical
        examinations may be performed and recorded according to qualification standards
        adopted by the Plan/Participating Transportation Provider, provided the medical
        examination qualification standards adopted by the Plan/Participating
        Transportation Provider meet or exceed those provided in Department Form
        Number
        725-030-11, Medical Examination Report for Bus Transit System
        Driver,
        Rev.
        07/05,
        hereby incorporated by reference.16

       

      
        	 	
                2.

              	
                Medical
                  examinations shall be performed by a Doctor of Medicine or Osteopathy,
                  a
                  PA or ARNP licensed or certified by the State of Florida. The examination
                  shall be conducted in person, and not via the Internet. If medical
                  examinations are performed by a PA or ARNP, they must
                  be

              

      

       

      16
        Copies
        of Form Number 725-030-11 are available from the Florida Department of
        Transportation, Public Transit Office, 605 Suwannee Street, Mail Station
        26,
        Tallahassee, Florida 32399-0450 or on-line at
        www.dot.state.fl.us/transit.

       

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      performed
        under the supervision or review of a Doctor of Medicine or

      Osteopathy.

       

      (a) An
        ophthalmologist or optometrist licensed by the State of Florida may perform
        as
        much of the examination as pertains to visual acuity, field of vision and
        color
        recognition.

       

      (b) Upon
        completion of the examination, the examining medical professional shall
        complete, sign, and date the medical examination report.

       

      3. The
        Plan/Participating Transportation Provider shall have on file proof of medical
        examination, i.e., a completed and signed medical examination report for
        each
        driver, dated within the past 24 months. Medical examination reports of employee
        drivers shall be maintained by the Plan/Participating Transportation Provider
        for a minimum of five (5) years from the date of the examination.

       

      j. Operational
        and Driving Requirements

       

      1. The
        Plan/Participating Transportation Provider shall not permit a driver to drive
        a
        vehicle when such driver's license has been suspended, canceled or revoked.
        The
        Plan/Participating Transportation Provider shall require a driver who receives
        a
        notice that his or her license to operate a motor vehicle has been suspended,
        canceled, or revoked notify his or her employer of the contents of the notice
        immediately, and no later than the end of the business day following the
        day he
        or she received the notice.

       

      2. At
        all
        times, the Plan/Participating Transportation Provider shall operate vehicles
        in
        compliance with applicable traffic regulations, ordinances and laws of the
        jurisdiction in which they are being operated.

       

      3. The
        Plan/Participating Transportation Provider shall not permit or require a
        driver
        to drive more than twelve (12) hours in any one 24-hour period, or drive
        after
        having been on duty for sixteen (16) hours in any one 24-hour period. The
        Plan/Participating Transportation Provider shall not permit a driver to drive
        until the driver fulfills the requirement of a minimum eight (8) consecutive
        hours off-duty. A driver's work period shall begin from the time he or she
        first
        reports for duty to his or her employer. A driver is permitted to exceed
        his or
        her regulated hours in order to reach a regularly established relief or dispatch
        point, provided the additional driving time does not exceed one (1)
        hour.

       

      4. The
        Plan/Participating Transportation Provider shall not permit or require a
        driver
        to be on duty more than 72 hours in any period of seven (7) consecutive days;
        however, 24 consecutive hours off-duty shall constitute

       

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      the
        end
        of any such period of seven (7) consecutive days. The Plan/Participating
        Transportation Provider shall ensure that a driver who has reached the maximum
        72 hours of on-duty time during the seven (7) consecutive days has a minimum
        of
        24 consecutive hours off-duty before returning to on-duty status.

       

      5. A
        driver
        is permitted to drive for more than the regulated hours for safety and
        protection of the public due to conditions such as adverse weather, disaster,
        security threat, a road or traffic condition, medical emergency or an
        accident.

       

      6. The
        Plan/Participating Transportation Provider shall not permit or require any
        driver to drive when his or her ability is impaired, or likely to be impaired,
        by fatigue, illness, or other causes, as to make it unsafe for the driver
        to
        begin or continue driving.

       

      7. The
        Plan/Participating Transportation Provider shall require pre-operational
        or
        daily inspection of all vehicles and reporting of all defects and deficiencies
        likely to affect safe operation or cause mechanical malfunctions.

       

      (a) The
        Plan/Participating Transportation Provider shall maintain a log detailing
        a
        daily inspection or test of the following parts and devices to ascertain
        that
        they are in safe condition and in good working order:

       

      (1) Service
        brakes;

       

      (2) Parking
        brakes;

       

      (3) Tires
        and
        wheels;

       

      (4) Steering;

       

      (5) Horn;

       

      (6) Lighting
        devices;

       

      (7) Windshield
        wipers;

       

      (8) Rear
        vision mirrors;

       

      (9) Passenger
        doors and seats;

       

      (10) Exhaust
        system;

       

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      (11) Equipment
        for transporting wheelchairs; and

       

      (12) Safety,
        security, and emergency equipment.

       

      (b) The
        Plan/Participating Transportation Provider shall review daily inspection
        reports
        and document corrective actions taken as a result of any deficiencies identified
        by any inspections.

       

      (c) The
        Plan/Participating Transportation Provider shall retain records of all
        inspections and any corrective action documentation for five (5)
        years.

       

      8. The
        driver shall not operate a vehicle with passenger doors in the open position
        when passengers are aboard. The driver shall not open the vehicle's doors
        until
        the vehicle comes to a complete stop. The Plan/Participating Transportation
        Provider shall not operate a vehicle with inoperable passenger doors with
        passengers aboard, except to move the vehicle to a safe location.

       

      
        	 	
                9.

              	
                During
                  darkness, interior lighting and lighting in stepwells on vehicles
                  shall be
                  sufficient for passengers to enter and exit
                  safely.

              

      

       

      10. Passenger(s)
        shall not be permitted in the stepwell(s) of any vehicle while the vehicle
        is in
        motion, or to occupy an area forward of the standee line.

       

      11. Passenger(s)
        shall not be permitted to stand on or in vehicles not designed and constructed
        for that purpose.

       

      12. The
        Plan/Participating Transportation Provider shall not refuel vehicles in a
        closed
        building. The Plan/Participating Transportation Provider shall minimize the
        number of times a vehicle shall refuel when passengers are onboard.

       

      13. The
        Plan/Participating Transportation Provider shall require the driver to be
        properly secured to the driver's seat with a restraining belt at all times
        while
        the vehicle is in motion.

       

      14. The
        driver shall not leave vehicles unattended with passenger(s) aboard for longer
        than five (5) minutes. The Plan/Participating Transportation Provider shall
        ensure that the driver sets the parking or holding brake any time the vehicle
        is
        left unattended.

       

      15. The
        Plan/Participating Transportation Provider shall not leave vehicles unattended
        in an unsafe condition with passenger(s) aboard at any time.

       

      k. Vehicle
        Equipment Standards and Procurement Criteria

       

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      1. The
        Plan/Participating Transportation Provider shall ensure that vehicles procured
        and operated meet the following requirements, at a minimum:

       

      (a) The
        capability and strength to carry the maximum allowed load and not exceed
        the
        manufacturer's gross vehicle weight rating (GVWR), gross axle weighting,
        or tire
        rating;

      

      (b) Structural
        integrity that mitigates or minimizes the adverse effects of collisions;
        and

       

      (c) Federal
        Motor Vehicle Safety Standards (FMVSS), 49 C.F.R. Part 571, Sections 102,
        103,
        104, 105, 108, 207, 209, 210, 217, 220, 221, 225, 302, 403, and 404, October
        1,
        2004, are hereby incorporated by reference.

       

      2. Proof
        of
        strength and structural integrity tests on new vehicles procured shall be
        submitted by manufacturers or the Plan/Participating Transportation Providers
        to
        the Department of Transportation.17

       

      3. The
        Plan/Participating Transportation Provider shall ensure that every vehicle
        operated in this State in connection with this Contract shall be equipped
        as
        follows:

       

      (a) Mirrors
        -
        There must be at least two (2) exterior rear vision mirrors, one (1) at each
        side. The mirrors shall be firmly attached to the outside of the vehicle
        and so
        located as to reflect to the driver a view to the rear along both sides of
        the
        vehicle.

       

      (1) Each
        exterior rear vision mirror, on Type I buses shall have a minimum reflective
        surface of 50 square inches and the right (curbside) mirror shall be located
        on
        the bus so that the lowest part of the mirror and its mounting is a minimum
        80
        inches above the ground. All Type I buses shall be equipped with an inside
        rear
        vision mirror capable of giving the driver a clear view of seated or standing
        passengers. Buses having a passenger exit door that is located inconveniently
        for the driver's visual control shall be equipped with additional interior
        mirror(s), enabling the driver to view the passenger exit door. The exterior
        right (curbside) rear vision mirror and its mounting on Type I buses may
        be
        located lower than 80 inches from the ground, provided such buses are used
        exclusively for paratransit services2 .

       

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      (2) In
        lieu
        of interior mirrors, trailer buses and articulated buses may be equipped
        with
        closed circuit video systems or adult monitors in voice control with the
        driver.

       

      (b) Wiring
        and Battery - Electrical wiring shall be maintained so as not to come in
        contact
        with moving parts, or heated surfaces, or be subject to chafing or abrasion
        which may cause insulation to

      become
        worn.

       

      (1) Every
        Type I bus manufactured on or after February 7, 1988, shall be equipped with
        a
        storage battery(ies) electrical power main disconnect switch. The disconnect
        switch shall be practicably located in an accessible location adjacent to
        or
        near to the battery(ies) and be legibly and permanently marked for
        identification.

       

      (2) Every
        storage battery on each public-sector bus shall be mounted with proper
        retainment devices in a compartment which provides adequate ventilation and
        drainage.

       

      (c) Brake
        Interlock Systems - All Type I buses having a rear exit door shall be equipped
        with a rear exit door/brake interlock that automatically applies the brake(s)
        upon driver activation of the rear exit door to the open position. Interlock
        brake application shall remain activated until deactivation by the driver
        and
        the rear exit door returns to the closed position. The rear exit door interlock
        on such buses shall be equipped with an identified override switch enabling
        emergency release of the interlock function, which shall not be located within
        reach of the seated driver. Air pressure application to the brake(s) during
        interlock operation, on buses equipped with rear exit door/brake interlock,
        shall be regulated at the original equipment manufacturer's
        specifications.

       

      4. Standee
        Line and Warning - Every vehicle designed and constructed to allow standees
        shall be plainly marked with a line of contrasting color at least two (2)
        inches
        wide or be equipped with some other means to indicate that any passenger
        is
        prohibited from occupying a space forward of a perpendicular plane drawn
        through
        the rear of the driver's seat and perpendicular to the longitudinal axis
        of the
        vehicle. A sign shall be posted at or near the front of the vehicle stating
        that
        it is a violation for a vehicle to be operated with passengers occupying
        an area
        forward of the line.

       

      5. Handrails
        and Stanchions - Every vehicle designed and constructed to allow standees
        shall
        be equipped with overhead grab rails for standee passengers. Overhead grab
        rails
        shall be continuous, except for a gap at

       

      

       

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      the
        rear
        exit door, and terminate into vertical stanchions or turn up into a

      ceiling
        fastener.

       

      (a) Every
        Type I and Type II bus designed for carrying more than sixteen (16) passengers
        shall be equipped with grab handles, stanchions, or bars at least ten (10)
        inches long and installed to permit safe on-board circulation, seating and
        standing assistance, and boarding and unloading by elderly and handicapped
        persons. Type I buses shall be equipped with a safety bar and panel directly
        behind each entry and exit stepwell.

       

      
        	 	
                6.

              	
                Flooring,
                  Steps, and Thresholds - Flooring, steps, and thresholds on all
                  vehicles
                  shall have slip resistant surfaces without protruding or sharp
                  edges,
                  lips, or overhangs, to prevent tripping hazards. All step edges
                  and
                  thresholds shall have a band of color(s) running the full width
                  of the
                  step or edge which contrasts with the step tread and riser, either
                  light-on-dark or dark-on-light.

              

      

       

      
        	 	
                7.

              	
                Doors
                  - Power activated doors on all vehicles shall be equipped with
                  a manual
                  device designed to release door closing
                  pressure.

              

      

       

      
        	 	
                8.

              	
                Emergency
                  Exits - All vehicles shall have an emergency exit door, or in lieu
                  thereof, shall be provided with emergency escape push-out windows.
                  Each
                  emergency escape window shall be in a form of a parallelogram with
                  dimensions of not less than 18" by 24", and each shall contain
                  an area of
                  not less than 432 square inches. There shall be a sufficient number
                  of
                  such push-out or kick-out windows in each vehicle to provide a
                  total
                  escape area equivalent to 67 square inches per seat, including
                  the
                  driver's seat.

              

      

       

      (a) No
        less
        than forty percent (40%) of the total escape area shall be on one (1) side
        of
        the vehicle. Emergency escape kick-out or push-out windows and emergency
        exit
        doors shall be conspicuously marked by a sign or light and shall always be
        kept
        in good working order so that they may be readily opened in an
        emergency.

       

      (b) All
        such
        windows and doors shall not be obstructed by bars or other such means located
        either inside or outside so as to hinder escape. Vehicles equipped with an
        auxiliary door for emergency exit shall be equipped with an audible alarm
        and
        light indicating to the driver when a door is ajar or opened while the engine
        is
        running.

       

      (c) Supplemental
        security locks operable by a key are prohibited on emergency exit doors unless
        these security locks are equipped and

       

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      connected
        with an ignition interlock system or an audio visual alarm located in the
        driver's compartment. Any supplemental security lock system used on emergency
        exits shall be kept unlocked whenever a vehicle is in operation.

       

      9. Tires
        and
        Wheels - Tires shall be properly inflated in accordance with manufacturer's
        recommendations.

       

      (a) No
        vehicle shall be operated with a tread groove pattern depth:

       

      (1) Less
        than
        4/32 (1/8) of an inch, measured at any point on a major tread groove for
        tires
        on the steering axle of all vehicles. The measurements shall not be made
        where
        tie bars, humps, or fillets are located.

       

      (2) Less
        than
        2/32 (1/16) of an inch, measured at any point on a major tread groove for
        all
        other tires of all vehicles. The measurements shall not be made where tie
        bars,
        humps, or fillets are located.

       

      
        	 	
                (b)

              	
                The
                  Plan/Participating Transportation Provider shall not operate any
                  vehicle
                  with recapped, regrooved, or retreaded tires on the steering
                  axle.

              

      

       

      
        	 	
                (c)

              	
                Wheels
                  shall be visibly free from cracks and distortion and shall not
                  have
                  missing, cracked, or broken mounting
                  lugs.

              

      

       

      10. Suspension
        - The suspension system of all vehicles, including springs, air bags, and
        all
        other suspension parts as applicable, shall be free from cracks, leaks, or
        any
        other defect which would or may cause its impairment or failure to function
        properly.

       

      11. Steering
        and Front Axle - The steering system of all vehicles shall have no indication
        of
        leaks which would or may cause its impairment to function properly, and shall
        be
        free from cracks and excessive wear of components that would or may cause
        excessive free play or loose motion in the steering system or above normal
        effort in steering control.

       

      12. Seat
        Belts - Every vehicle shall be equipped with an adjustable driver's restraining
        belt in compliance with the requirements of FMVSS 209, "Seat Belt
        Assemblies"19
        and
        FMVSS 210, "Seat Belt Assembly Anchorages."20

       

      19
        See 49
        C.F.R. 571.209,2004.

      20
        See 49
        C.F.R. 571.210,2004.

       

      AHCA
        Contract No. FA522, Amendment No. 10, Page 22 of 29

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      Medicaid
        HMO Contract

       

      13. Safety
        Equipment - Every vehicle shall be equipped with one (1) fully charged dry
        chemical or carbon dioxide fire extinguisher, having at least a 1A:BC rating
        and
        bearing the label of Underwriter's Laboratory, Inc.

       

      
        	 	
                (a)

              	
                Each
                  fire extinguisher shall be securely mounted on the vehicle in a
                  conspicuous place or a clearly marked compartment and be readily
                  accessible.

              

      

       

      
        	 	
                (b)

              	
                Each
                  fire extinguisher shall be maintained in efficient operating condition
                  and
                  equipped with some means of determining if it is fully
                  charged.

              

      

       

      
        	 	
                (c)

              	
                Every
                  Type I bus shall be equipped with portable red reflector warning
                  devices.21

              

      

       

      

      14. Vehicles
        used for the purpose of transporting individuals with disabilities shall
        meet
        the requirements set forth in 49 C.F.R. Part 38, October 1, 2004, hereby
        incorporated by reference, and the following:

       

      
        	 	
                (a)

              	
                Installation
                  of a wheelchair lift or ramp shall not cause the manufacturer's
                  GVWR,
                  gross axle weight rating, or tire rating to be
                  exceeded.

              

      

       

      (b) Except
        in
        locations within 31/2 inches of the vehicle floor, all readily accessible
        exposed edges or other hazardous protrusions of parts of wheelchair lift
        assemblies or ramps that are located in the passenger compartment shall be
        padded with energy absorbing material to mitigate injury in normal use and
        in
        case of a collision. This requirement shall also apply to parts of the vehicle
        associated with the operation of the lift or ramp.

       

      (c) The
        controls for operating the lift shall be at a location where the driver or
        lift
        attendant has a full view, unobstructed by passengers, of the lift platform,
        its
        entrance and exit, and the wheelchair passenger, either directly or with
        partial
        assistance of mirrors. Lifts located entirely to the rear of the driver's
        seat
        shall not be operable from the driver's seat, but shall have an override
        control
        at the driver's position that can be activated to prevent the lift from being
        operated by the other controls (except for emergency manual operation upon
        power
        failure).

       

      (d) The
        installation of the wheelchair lift or ramp and its controls and the method
        of
        attachment in the vehicle body or chassis shall not diminish the structural
        integrity of the vehicle nor cause a hazardous imbalance of the vehicle.
        No part
        of the assembly, when installed and stowed, shall extend laterally beyond
        the

       

      21
        See
        section 316.300, F.S., 2004.

       

      AHCA
        Contract No. FA522, Amendment No. 10, Page 23 of 29

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      Medicaid
        HMD Contract

       

      normal
        side contour of the vehicle or vertically beyond the lowest part of the rim
        of
        the wheel closest to the lift.

       

      (e) Each
        wheelchair lift or ramp assembly shall be legibly and permanently marked
        by the
        manufacturer or installer with the following minimum information:

      (1) The
        manufacturer's name and address;

      (2) The
        month
        and year of manufacture; and

      (3) A
        certificate that the wheelchair lift or ramp securement devices, and their
        installation, conform to State of Florida requirements applicable to accessible
        vehicles.

       

      15. Wheelchair
        lifts, ramps, securement devices, and restraints shall be inspected and
        maintained as required in this Section, above. Instructions for normal and
        emergency operation of the lift or ramp shall be carried or displayed in
        every
        vehicle.

       

      1. Vehicle
        Safety Inspections

       

      1. The
        Plan/Participating Transportation Provider shall require that all vehicles
        be
        inspected in accordance with the vehicle inspection procedures set forth
        above.

       

      
        	 	
                2.

              	
                It
                  is the Plan's/Participating Transportation Provider's responsibility
                  to
                  ensure that each individual performing a vehicle safety inspection
                  is
                  qualified as follows:

              

      

       

      (a) Understands
        the requirements set forth in 14-90, F.A.C., 2004 and can identify defective
        components;

       

      (b) Is
        knowledgeable of, and has mastered the methods, procedures, tools, and equipment
        used when performing an inspection; and

       

      (c) Has
        at
        least one (1) year of training and/or experience as a mechanic or inspector
        in a
        vehicle maintenance program and has sufficient general knowledge of vehicles
        owned and operated by the Plan/Participating Transportation Provider to
        recognize deficiencies or mechanical defects.

       

      3. The
        Plan/Participating Transportation Provider shall ensure that each vehicle
        receiving a safety inspection is checked for compliance with the safety devices
        and equipment requirements as referenced or specified above. Specific operable
        equipment and devices include the following:

       

      (a)  Horn;

       

      AHCA
        Contract No. FA522, Amendment No. 10, Page 24 of 29

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      Medicaid
        HMO Contract

       

      (b) Windshield
        wipers;

       

      (c) Mirrors;

       

      (d) Wiring
        and battery(ies);

       

      (e) Service
        and parking brakes;

       

      (f) Warning
        devices;

       

      (g) Directional
        signals;

       

      (h)
        Hazard warning signals;

       

      (i) Lighting
        systems and signaling devices;

       

      (j) Handrails
        and stanchions;

       

      (k) Standee
        line and warning;

       

      (1) Doors
        and
        interlock devices;

       

      (m) Stepwells
        and flooring;

       

      (n) Emergency
        exits;

       

      (o) Tires
        and
        wheels;

       

      (p) Suspension
        system;

       

      (q) Steering
        system;

       

      (r) Exhaust
        system;

       

      (s) Seat
        belts;

       

      (t) Safety
        equipment; and

       

      (u) Equipment
        for transporting wheelchairs.

       

      4. A
        safety
        inspection report shall be prepared by the individual(s) performing the
        inspection which shall include the following:

       

      (a) Identification
        of the individual(s) performing the inspection;

      (b) Identification
        of the Plan/Participating Transportation Provider operating the
        vehicle;

       

      AHCA
        Contract No. FA522, Amendment No. 10, Page 25 of 29

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      Medicaid
        HMO Contract

       

      (c) The
        date
        of the inspection;

      (d) Identification
        of the vehicle inspected;

      (e) Identification
        of the equipment and devices inspected including the identification of equipment
        and devices found deficient or defective; and

      (f) Identification
        of corrective action(s) for deficient or defective items and date(s) of
        completion of corrective action(s).

       

      5. Records
        of annual safety inspections and documentation of any required corrective
        actions shall be retained for compliance review a minimum of five (5) years
        by
        the Plan/Participating Transportation Provider.

       

      m. Certification
        - Each Plan/Participating Transportation Provider shall submit to the Bureau
        of
        Managed Health Care an annual safety and security certification in accordance
        with 14-90.10, F.A.C., 2004 and shall submit in the format set forth in 14-90.10
        and 14-90.12, F.A.C., 2004.

       

      n. The
        Plan
        shall report the following by August 15th
        of each
        year:

       

      (1) The
        estimated number of one-way passenger trips to be provided during the coming
        fiscal year in the following categories:

       

      (a) Ambulatory
        transportation;

       

      (b) Long
        haul
        ambulatory transportation;

       

      (c) Wheelchair
        transportation;

       

      (d) Stretcher
        transportation;

       

      (e) Ambulatory
        multiload transportation;

       

      (f) Wheelchair
        multiload transportation;

       

      (g) Mass
        transit pending transportation;

       

      (h) Mass
        transit transportation;

       

      (i) Mass
        transit transportation (Enrollee has pass); and

       

      (j) Mass
        transit transportation (sent pass to Enrollee).

       

      (2) The
        actual amount of funds expended and the total number of trips provided during
        the previous fiscal year; and

       

      (3) The
        operating financial statistics for the previous fiscal year.

       

      22
        As
        defined in the Transportation Handbook.

       

      AHCA
        Contract No. FA522, Amendment No. 10, Page 26 of 29

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      Medicaid
        HMO Contract

       

      o. Shall
        provide the total number of vehicles in each category, other than public
        transportation, that will serve each County as well as a provider directory
        for
        all Transportation Services."

       

      
        	 	
                4.

              	
                Attachment
                  VIII, Estimated 2005-2006 Rates; Not for use unless approved by
                  CMS, is
                  hereby deleted in its entirety and replaced with Attachment VIII-A,
                  2005/2006 Medicaid HMO Capitation
                  Rates.

              

      

       

      
        	
                5.

              	
                Attachment
                  I, Section 90.0, Payment and Authorized Enrollment Levels, Tables
                  2 and 3,
                  are hereby deleted in their entirety and replaced with the
                  following:

              

      

       

      Capitation
        Rates

       

      A. General
        Capitation Rates (Attachment VIII-A, Table I):

       

      Area
        9 Counties: Palm Beach

       

      County   Provider
        Number

      Palm
        Beach  015016910

       

      Area
        10 Counties: Broward

       

      County   Provider
        Number

      Broward   015016900

       

      B. General
        Capitation Rates plus Mental Health Rates (Attachment VIII-A, Table
        4):

       

      Area
        3 Counties: Hernando

       

      County   Provider
        Number

      Hemando  015016901

       

      Area
        5 Counties: Pasco, Pinellas

       

      County   Provider
        Number

      Pasco   015016903
        

      Pinellas   015016904

       

      Area
        6 Counties: Manatee, Polk

       

      County   Provider
        Number

      Manatee   015016912

      Polk   015016905

       

      AHCA
        Contract No. FA522, Amendment No. 10, Page 27 of 29

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      Medicaid
        HMO Contract

       

      Area
        7 Counties: Brevard

       

      County   Provider
        Number

      Brevard
           015016913

       

      Area
        8 Counties:
        Sarasota, Lee

       

      County   Provider
        Number

      Sarasota   015016914
        

      Lee   015016911

       

      Area
        11 Counties: Dade

       

      County   Provider
        Number

      Dade   015016909

       

      C. General
        Capitation Rates plus Mental Health Rates and Transportation Rates (Attachment
        VIII-A, Table 6):

       

      Area
        6 Counties: Hillsborough

       

      County   Provider
        Number

      Hillsborough  015016902

       

      Area
        7 Counties: Orange, Osceola, Seminole

       

      County   Provider
        Number

      Orange   015016906
        

      Osceola   015016907
        

      Seminole  015016908

       

      Notwithstanding
        the payment amounts which may be computed with the above rate table, the
        sum of
        total capitation payments under this contract shall not exceed the
        total-contract amount of $665,594,194.00 (an increase of $1,836,972.00),
        expressed on page seven of this contract.

       

      
        	
                6.

              	
                This
                  Amendment shall have an effective date of December 1,2005, 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.

       

      AHCA
        Contract No. FA522, Amendment No. 10, Page 28 of 29

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      Medicaid
        HMO Contract

       

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

       

      This
        Amendment can not be executed unless all previous amendments to this Contract
        have been fully executed.

       

      IN
        WITNESS WHEREOF,
        the
        Parties have caused this 32 page Amendment (including all attachments, if
        any)
        to be executed by their duly authorized officials. 

      
        	
                 

                WELL
                  CARE HMO, INC. D/B/A STAYWELL HEALTH PLAN OF FLORIDA

                SIGNED

                BY:/s/
                  Todd S. Farha

                NAME:
                  Todd
                  S. Farha 

                TITLE:
                  President
                  & CEO

                DATE:
                  12/2/05

              	
                 

                STATE
                  OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION

                SIGNED
                  

                BY:
                  [ILLEGIBLE]_

                NAME:
                  Alan
                  Levine

                TITLE:
                  Secretary 

                DATE:12/6/05

              

      

       

      

       

      List
        of
        attachments included as part of this Amendment:

       

      

      Specify
        

      Type_______ Number   Description       

      Attachment VIII-A  2005/2006
        Medicaid HMO Capitation Rates (3 pages)

      

      REMAINDER
        OF PAGE INTENTIONALLY LEFT BLANK 

      

      

      

      

      

      

      

      

      

      

      

      

      

      

      AHCA
        Contract No. FA522, Amendment No. 10, Page 29 of 29

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      ATTACHMENT
        Vlll-A 2005/2006 MEDICAID HMO CAPITATION RATES

      By
        Area, Age and Eligibility Category 

      Effective
        from July 1, 2005 thru June 30, 2006

      
        	
                TABLE
                  1

              
	
                 

                General
                  Rates: Effect from July 1, 05 - Dec 31, 05

              	
                 

                Effect
                  from Jan 1, 06 - June 30, 06

              
	 	
                 

                TANF

              	
                 

                SSI-NO
                  MEDICARE

              	
                 

                SSI-B

              	
                 

                SSI-AB

              	
                 

                SSI-B

              	
                 

                SSI-AB

              
	
                 

                Area

              	
                 

                THMO

                 

                +2MO

              	
                 

                3MO-

                 

                11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE

                 

                (14-20)

                 

                 

              	
                 

                AGE

                 

                (21-54)

                 

              	
                 

                AGE

                 

                (55+)

              	
                 

                BTHMO+2MO

              	
                 

                3MO-11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE
                  (14-20)

              	
                 

                AGE
                  (21-54)

              	
                 

                AGE

                 

                (55+)

              	 	
                 

                AGE
                  

                 

                (65-)

              	
                 

                AGE
                  (65+)

              	 	
                 

                AGE
                  (65-)

              	
                 

                AGE
                  (65+)

              
	 	 	 	 	 	
                Female

              	
                Male
                  

              	
                Female

              	
                Male

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                 

                01

              	
                 

                856.85

              	
                 

                169.63

              	
                 

                82.99

              	
                 

                52.45

              	
                 

                116.16

              	
                 

                58.88

              	
                 

                223.51

              	
                 

                144.11

              	
                 

                299.66

              	
                 

                8,379.19

              	
                 

                1,456.18

              	
                 

                373.32

              	
                 

                192.70

              	
                 

                211.00

              	
                 

                636.93

              	
                 

                598.64

              	
                 

                359.76

              	
                 

                314.95

              	
                 

                219.52

              	
                 

                213.89

              	
                 

                77.80

              	
                 

                67.94

              
	
                02

              	
                856.85

              	
                169.63

              	
                82.99

              	
                52.45

              	
                116.16

              	
                58.88

              	
                223.51

              	
                144.11

              	
                299.66

              	
                8,379.19

              	
                1,456.18

              	
                373.32

              	
                192.70

              	
                211.00

              	
                636.93

              	
                538.84

              	
                359.76

              	
                314.95

              	
                219.52

              	
                213.89

              	
                77.80

              	
                67.94

              
	
                03

              	
                956.50

              	
                190.36

              	
                93.47

              	
                59.66

              	
                130.82

              	
                66.71

              	
                252.75

              	
                163.57

              	
                340.95

              	
                8,796.55

              	
                1,536.62

              	
                394.23

              	
                205.64

              	
                225.15

              	
                679.21

              	
                639.39

              	
                347.95

              	
                292.11

              	
                203.81

              	
                229.06

              	
                75.70

              	
                66.16

              
	
                04

              	
                877.98

              	
                175.54

              	
                86.37

              	
                55.47

              	
                120.97

              	
                62.05

              	
                234,40

              	
                152.22

              	
                317.36

              	
                8,571.85

              	
                1,495.58

              	
                383.99

              	
                199.57

              	
                218.39

              	
                659.82

              	
                620.93

              	
                333.59

              	
                294.49

              	
                205.57

              	
                207.10

              	
                77.20

              	
                67.39

              
	
                05

              	
                919.97

              	
                183.42

              	
                90.13

              	
                57.68

              	
                126.15

              	
                64.46

              	
                244.02

              	
                158.18

              	
                329.69

              	
                9,248.01

              	
                1,615.40

              	
                414.34

              	
                216.54

              	
                236.27

              	
                713.54

              	
                671.88

              	
                327.76

              	
                311.44

              	
                217.30

              	
                209.72

              	
                74.11

              	
                64.73

              
	
                06

              	
                839.89

              	
                168.12

              	
                82.82

              	
                53.24

              	
                115.99

              	
                59.56

              	
                224.94

              	
                146.07

              	
                305.02

              	
                8,536.48

              	
                1,494.27

              	
                383.60

              	
                201.12

              	
                219.94

              	
                663,51

              	
                624.96

              	
                318.14

              	
                283,93

              	
                198.16

              	
                200.02

              	
                68.93

              	
                60.15

              
	
                 

                07

              	
                 

                894.04

              	
                 

                178.56

              	
                 

                87.80

              	
                 

                56.33

              	
                 

                122.97

              	
                 

                63.04

              	
                 

                238.18

              	
                 

                154.51

              	
                 

                322.34

              	
                 

                8,976.51

              	
                 

                1,573.97

              	
                 

                404.51

              	
                 

                212.74

              	
                 

                232.25

              	
                 

                701.12

              	
                 

                661.11

              	
                 

                308.90

              	
                 

                284.51

              	
                 

                198.54

              	
                 

                199.32

              	
                 

                72.42

              	
                 

                63.26

              
	
                 

                08

              	
                 

                785.52

              	
                 

                156.85

              	
                 

                77.12

              	
                 

                49.44

              	
                 

                107.94

              	
                 

                55.29

              	
                 

                209.14

              	
                 

                135.62

              	
                 

                282.90

              	
                 

                8,247.93

              	
                 

                1,440.20

              	
                 

                369.54

              	
                 

                192.51

              	
                 

                211.13

              	
                 

                636.41

              	
                 

                599.00

              	
                 

                306.59

              	
                 

                288.63

              	
                 

                201.43

              	
                 

                185.30

              	
                 

                69.18

              	
                 

                60.36

              
	
                 

                09

              	
                 

                850.65

              	
                 

                169.56

              	
                 

                83.32

              	
                 

                53.28

              	
                 

                116.63

              	
                 

                59.62

              	
                 

                225.69

              	
                 

                146.30

              	
                 

                304.86

              	
                 

                9,123.67

              	
                 

                1,599.06

              	
                 

                410.92

              	
                 

                216.11

              	
                 

                235.92

              	
                 

                711.70

              	
                 

                670.95

              	
                 

                288.69
                  

              	
                 

                317.25

              	
                 

                221.58

              	
                 

                179.44

              	
                 

                76.11

              	
                 

                66.48

              
	
                 

                10

              	
                 

                854.17

              	
                 

                170.86

              	
                 

                84.11

              	
                 

                54.07

              	
                 

                117.82

              	
                 

                60.56

              	
                 

                228.53

              	
                 

                148.48

              	
                 

                309.80

              	
                 

                11,134.67

              	
                 

                1,955.18

              	
                 

                502.14

              	
                 

                264.85

              	
                 

                289.15

              	
                 

                873.08

              	
                 

                823.33

              	
                 

                316.16

              	
                 

                341.03

              	
                 

                238.55

              	
                 

                205.90

              	
                 

                81.99

              	
                 

                71.59

              
	
                 

                11

              	
                 

                1,110.67

              	
                 

                220.94

              	
                 

                108.54

              	
                 

                69.08

              	
                 

                151.73

              	
                 

                77.37

              	
                 

                293.07

              	
                 

                189.70

              	
                 

                395.11

              	
                 

                12,135.43

              	
                 

                2,122.04

              	
                 

                545.24

              	
                 

                284.82

              	
                 

                311.87

              	
                 

                940.58

              	
                 

                885.79

              	
                 

                450.68
                  

              	
                 

                420.85

              	
                 

                294.28

              	
                 

                269.25

              	
                 

                112.55

              	
                 

                98.31

              
	
                TABLE
                  2

              
	
                 

                General
                  + Transportation Rates: Effect from July 1, 05 - Dec 31,
                  05

              	
                 

                Effect
                  from Jan 1, 06 - June 30, 06

              
	 	
                 

                TANF

              	
                 

                SSI-NO
                  MEDICARE

              	
                 

                SSI-B

              	
                 

                 

                SSI-AB

              	
                 

                SSI-B

              	
                SSI-AB

              
	
                 

                Area

              	
                 

                THMO+2MO

              	
                 

                3MO-

                 

                11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE

                 

                (14-20)

                 

                 

              	
                 

                AGE

                 

                (21-54)

                 

              	
                 

                AGE

                 

                (55+)

              	
                 

                THMO+2MO

              	
                 

                3MO-11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE
                  

                 

                (14-20)

              	
                 

                AGE

                 

                (21-54)

              	
                 

                AGE

                 

                (55+)

              	 	
                 

                AGE
                  

                 

                (65-)

              	
                 

                AGE
                  

                 

                (65+)

              	 	
                 

                AGE
                  (65-)

              	
                 

                AGE
                  (65+)

              
	 	 	 	 	 	
                 

                Female

              	
                 

                Male

              	
                 

                Female

              	
                 

                Male

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                 

                01
                  

              	
                 

                859.90

              	
                 

                170.76

              	
                 

                83.89

              	
                 

                53.10

              	
                 

                117.81

              	
                 

                59.91

              	
                 

                226.17

              	
                 

                145.81

              	
                 

                302.65

              	
                 

                8,391.86

              	
                 

                1,468.01

              	
                 

                380.72

              	
                 

                194.81

              	
                 

                214.84

              	
                 

                651.77

              	
                 

                609.36

              	
                 

                374.05

              	
                 

                331.44

              	
                 

                226.36

              	
                 

                228.18

              	
                 

                94.29

              	
                 

                74.78

              
	
                02
                  

              	
                859.90

              	
                170.76

              	
                83.89

              	
                53.10

              	
                117.81

              	
                59.91

              	
                226.17

              	
                145.81

              	
                302.65

              	
                8,391.86

              	
                1,468.01

              	
                380.72

              	
                194.81

              	
                214.84

              	
                651.77

              	
                609.36

              	
                374.05

              	
                331.44

              	
                226.36

              	
                226.18

              	
                94.29

              	
                74.78

              
	
                 

                03
                  

              	
                 

                959.98

              	
                 

                191.66

              	
                 

                94.50

              	
                 

                60.41

              	
                 

                132.70

              	
                 

                67.88

              	
                 

                255.80

              	
                 

                165.52

              	
                 

                344.37

              	
                 

                8,811.87

              	
                 

                1,550.92

              	
                 

                403.17

              	
                 

                208.19

              	
                 

                229.78

              	
                 

                697.16

              	
                 

                652.10

              	
                 

                358.59

              	
                 

                315.51

              	
                 

                213.51

              	
                 

                239.70

              	
                 

                99.10

              	
                 

                75.86

              
	
                04

              	
                880.32

              	
                176.41

              	
                87.06

              	
                55.97

              	
                122.24

              	
                62.84

              	
                236.45

              	
                153.53

              	
                319.66

              	
                8,588.73

              	
                1,511.34

              	
                393.86

              	
                202.38

              	
                223.50
                  

              	
                679.61
                  

              	
                634.95
                  

              	
                340.18

              	
                317.93
                  

              	
                215.29

              	
                213.69
                  

              	
                100.64
                  

              	
                77.11

              
	
                 

                05
                  

              	
                 

                922.10

              	
                 

                184.21

              	
                 

                90.76

              	
                 

                58.14

              	
                 

                127.30

              	
                 

                65.18

              	
                 

                245.89

              	
                 

                159.37

              	
                 

                331.78

              	
                 

                9,257.23

              	
                 

                1,624.00
                  

              	
                 

                419.72
                  

              	
                 

                218.07

              	
                 

                239.06

              	
                 

                724.34

              	
                 

                679.53

              	
                 

                333.32
                  

              	
                 

                325.59

              	
                 

                223.17
                  

              	
                 

                215.28

              	
                 

                88.26

              	
                 

                70.60
                  

              
	
                06

              	
                842.31

              	
                169.02

              	
                83.53

              	
                53.75

              	
                117.30

              	
                60.38

              	
                227.06

              	
                147.42

              	
                307.40

              	
                8,546.96

              	
                1,504.05

              	
                389.72

              	
                202.87

              	
                223.11

              	
                675.78

              	
                633.65

              	
                322.90

              	
                298.45

              	
                204.18

              	
                204.78

              	
                83.45

              	
                66.17

              
	
                07
                  

              	
                895.75

              	
                179.20

              	
                88.31

              	
                56.70

              	
                123.90

              	
                63.62

              	
                239.68

              	
                155.47

              	
                324.02

              	
                8,987.84

              	
                1,584.55

              	
                411.12

              	
                214.63

              	
                235.67

              	
                714.39

              	
                670.51

              	
                314.35

              	
                301.66

              	
                205.65

              	
                204.77

              	
                89.57

              	
                70.37

              
	
                08
                  

              	
                788.64

              	
                158.01

              	
                78.04

              	
                50.11

              	
                109.62

              	
                56.34

              	
                211.86

              	
                137.36

              	
                285.97

              	
                8.259.67

              	
                1,451.16

              	
                376.39

              	
                194.46

              	
                214.68

              	
                650.16

              	
                608.74

              	
                316.39

              	
                304.12

              	
                207.85

              	
                195.10

              	
                84.67

              	
                66.78

              
	
                 

                09
                  

              	
                 

                853.54

              	
                 

                170.64

              	
                 

                84.18

              	
                 

                53.90

              	
                 

                118.18

              	
                 

                60.59

              	
                 

                228.21

              	
                 

                147.91

              	
                 

                307.69

              	
                 

                9,136.00

              	
                 

                1,610.58

              	
                 

                418.13

              	
                 

                218.16

              	
                 

                239.64

              	
                 

                726.15

              	
                 

                681.19

              	
                 

                293.10

              	
                 

                336.49

              	
                 

                229.56

              	
                 

                183.85

              	
                 

                95.35

              	
                 

                74.46

              
	
                 

                10
                  

              	
                 

                856.36

              	
                 

                171.67
                  

              	
                 

                84.76
                  . 

              	
                 

                54.54
                  

              	
                 

                119.01

              	
                 

                61.30

              	
                 

                230.45

              	
                 

                149.70

              	
                 

                311.95

              	
                 

                11,151.24

              	
                 

                1,970.64

              	
                 

                511.81

              	
                 

                267.61

              	
                 

                294.16

              	
                 

                892.47

              	
                 

                837.08
                  

              	
                 

                322.46
                  

              	
                 

                363.21
                  

              	
                 

                247.75
                  

              	
                 

                212.17
                  

              	
                 

                104.17
                  

              	
                 

                80.79
                  

              
	
                 

                11

              	
                 

                1,112.08

              	
                 

                221.47

              	
                 

                108.96

              	
                 

                69.38

              	
                 

                152.49

              	
                 

                77.84

              	
                 

                294.30

              	
                 

                190.48

              	
                 

                369.50

              	
                 

                12,145.44

              	
                 

                2,131.38

              	
                 

                551.08

              	
                 

                286.49

              	
                 

                314.89

              	
                 

                952.30

              	
                 

                894.10

              	
                 

                455.34

              	
                 

                433.96

              	
                 

                299.72

              	
                 

                273.91

              	
                 

                125.66

              	
                 

                103.75

              
	
                TABLE
                  3

              	 
	
                 

                General
                  + Dental Rates: Effect from July 1, 05 - Dec 31, 05 Effect from
                  Jan 1, 06
                  - June 30, 06

              	
                 

                Effect
                  from Jan 1, 06 - June 30, 06

              
	 	
                 

                TANF

              	
                 

                SSI-NO
                  MEDICARE

              	
                 

                SSI-B

              	
                 

                 

                SSI-AB

              	
                 

                SSI-B

              	
                SSI-AB

              
	
                 

                Area

              	
                 

                THMO+2MO

              	
                 

                3MO-11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE

                 

                (14-20)

                 

                 

              	
                 

                AGE

                 

                (21-54)

                 

              	
                 

                AGE

                 

                (55+)

              	
                 

                THMO+2MO

              	
                 

                3MO-11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE

                 

                (14-20)

              	
                 

                AGE

                 

                (21-54)

              	
                 

                AGE

                 

                (55+)

              	 	
                 

                AGE

                 

                (65-)

              	
                 

                AGE

                 

                (65+)

              	 	
                 

                AGE
                  (65-)

              	
                 

                AGE
                  (65+)

              
	 	 	 	 	 	
                Female

              	
                Male

              	
                Female

              	
                Male

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                 

                01
                  

              	
                 

                856.85

              	
                 

                169.64

              	
                 

                85.68

              	
                 

                57.82

              	
                 

                122.00

              	
                 

                63.64

              	
                 

                224.53

              	
                 

                144.95

              	
                 

                300.28

              	
                 

                8,379.19

              	
                 

                1,456.20

              	
                 

                375.81

              	
                 

                196.65

              	
                 

                214.57

              	
                 

                636.22

              	
                 

                599.71

              	
                 

                359.86

              	
                 

                315.91

              	
                 

                219.89

              	
                 

                213.99

              	
                 

                78.76

              	
                 

                68.31

              
	
                02
                  

              	
                856.85

              	
                169.64

              	
                85.68

              	
                57.82

              	
                122.00

              	
                63.64

              	
                224.53

              	
                144.95

              	
                300.28

              	
                8,379.19

              	
                1,456.20

              	
                375.81

              	
                196.65

              	
                214.57

              	
                636.22

              	
                599.71

              	
                359.86

              	
                315.91

              	
                219.89

              	
                213.99

              	
                78.76

              	
                68.31

              
	
                03
                  

              	
                956.50

              	
                190.37

              	
                96.77

              	
                66.24

              	
                137.98

              	
                72.54

              	
                256.08

              	
                166.32

              	
                342.99

              	
                8,796.55

              	
                1,536.65

              	
                397.67

              	
                211.11

              	
                230.10

              	
                681.91

              	
                641.21

              	
                349.31

              	
                294.26

              	
                204.63

              	
                230.42

              	
                77.85

              	
                66.98

              
	
                04
                  

              	
                877.98

              	
                175.55

              	
                88.68

              	
                60.09

              	
                125.99

              	
                66.14

              	
                237.63

              	
                154.89

              	
                319.33

              	
                8,571.85

              	
                1,495.60

              	
                386.54

              	
                203.61

              	
                222.05

              	
                662.50

              	
                622.74

              	
                334.80

              	
                296.81

              	
                206.45

              	
                208.31

              	
                79.52

              	
                68.27

              
	
                05
                  

              	
                919.96

              	
                183.44

              	
                93.94

              	
                65.28

              	
                134.42

              	
                71.19

              	
                254.18

              	
                166.58

              	
                335.91

              	
                9,248.01

              	
                1,615.44

              	
                419.19

              	
                224.23

              	
                243.23

              	
                719.05

              	
                675.60

              	
                332.66

              	
                317.69

              	
                219.69

              	
                214.62

              	
                80.36

              	
                67.12

              
	
                06
                  

              	
                839.89

              	
                168.13

              	
                85.94

              	
                59.43

              	
                122.74

              	
                65,05

              	
                231.04

              	
                151.11

              	
                308.75

              	
                8,536.48

              	
                1,494.30

              	
                387.15

              	
                206.75

              	
                225.03

              	
                668.52

              	
                628.34

              	
                320.73

              	
                288.82

              	
                200.03

              	
                202.61

              	
                73.82

              	
                62.02

              
	
                07
                  

              	
                894.04

              	
                178.57

              	
                90.51

              	
                61.74

              	
                128.85

              	
                67.83

              	
                243.93

              	
                159.26

              	
                325.86

              	
                8,976.51

              	
                1,574.00

              	
                407.86

              	
                218.05

              	
                237.05

              	
                704.74

              	
                663.55

              	
                310.08

              	
                287.80

              	
                199.80

              	
                200.50

              	
                75.71

              	
                64.52

              
	
                08
                  

              	
                785.52

              	
                156.86

              	
                79.85

              	
                54.89

              	
                113.87

              	
                60.13

              	
                214.88

              	
                140.36

              	
                286.42

              	
                8,247.93

              	
                1,440.22

              	
                372.40

              	
                197.06

              	
                215.24

              	
                641.03

              	
                602.12

              	
                309.05

              	
                292.56

              	
                202.94

              	
                187.76

              	
                73.11

              	
                61.87

              
	
                09
                  

              	
                850.66

              	
                169.58

              	
                86.89

              	
                60.40

              	
                124.38

              	
                65.93

              	
                229.41

              	
                149.37

              	
                307.13

              	
                9,123.67

              	
                1,599.08

              	
                414.10

              	
                221.16

              	
                240.49

              	
                714.60

              	
                672.91

              	
                289.96

              	
                319.90

              	
                222.59

              	
                180.71

              	
                78.73

              	
                67.49

              
	
                10
                  

              	
                854.17

              	
                170.87

              	
                87.29

              	
                60.43

              	
                124.73

              	
                66.19

              	
                231.56

              	
                150.99

              	
                311.65

              	
                11,134.67

              	
                1,955.21

              	
                506.08

              	
                271.11

              	
                294.81

              	
                876.08

              	
                825.36

              	
                317.65

              	
                344.02

              	
                239.70

              	
                207.36

              	
                84.98

              	
                72.74

              
	
                11
                  

              	
                1.110.68

              	
                220.96

              	
                112.49

              	
                76.96

              	
                160.31

              	
                84.36

              	
                296.12

              	
                192.22

              	
                396.97

              	
                12,135.43

              	
                2,122.07

              	
                549.62

              	
                291.76

              	
                318.15

              	
                943.63

              	
                887.85

              	
                452.12

              	
                423.36

              	
                295.43

              	
                270.69

              	
                115.56

              	
                99.46

              

      

      

      

      AHCA
        Contract No. FA522, Attachment Vlll-A, Page 1 of 3

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      

      
        	
                TABLE
                  4

              
	
                 

                General
                  + Mental Health Rates Effect from July 1, 05 - Dec 31,
                  05

                 

                Effect
                  from July 1, 05 - Dec 31, 05

              	
                 

                Effect
                  from Jan 1, 06 - June 30, 06

              
	 	
                 

                TANF

              	
                 

                SSI-NO
                  MEDICARE

              	
                 

                SSI-B

              	
                 

                SSI-AB

              	
                 

                SSI-B

              	
                 

                SSI-AB

              
	
                 

                Area

              	
                 

                THMO

                 

                +2MO

              	
                 

                3MO-

                 

                11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE

                 

                (14-20)

                 

                 

              	
                 

                AGE

                 

                (21-54)

                 

              	
                 

                AGE

                 

                (55+)

              	
                 

                BTHMO+2MO

              	
                 

                3MO-11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE
                  (14-20)

              	
                 

                AGE
                  (21-54)

              	
                 

                AGE

                 

                (55+)

              	 	
                 

                AGE
                  

                 

                (65-)

              	
                 

                AGE
                  (65+)

              	 	
                 

                AGE
                  (65-)

              	
                 

                AGE
                  (65+)

              
	 	 	 	 	 	
                Female

              	
                Male
                  

              	
                Female

              	
                Male

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                 

                01

              	
                 

                856.85

              	
                 

                169.64

              	
                 

                84.58

              	
                 

                64.23

              	
                 

                128.66

              	
                 

                71.38

              	
                 

                227.66

              	
                 

                148.26

              	
                 

                303.38

              	
                 

                8,379.21

              	
                 

                1,456.20

              	
                 

                384.40

              	
                 

                263.28

              	
                 

                284.40

              	
                 

                732.06

              	
                 

                631.82

              	
                 

                367.49

              	
                 

                331.54

              	
                 

                236.11

              	
                 

                221.62

              	
                 

                94.39

              	
                 

                84.53

              
	
                02

              	
                856.87

              	
                169.65

              	
                85.36

              	
                69.25

              	
                128.93

              	
                71.65

              	
                226.56

              	
                147.16

              	
                302.78

              	
                8,379.20

              	
                1,456.19

              	
                388.93

              	
                278.27

              	
                264.36

              	
                690.25

              	
                621.15

              	
                380.79

              	
                328.39

              	
                232.96

              	
                234.92

              	
                91.24

              	
                81.38

              
	
                03

              	
                956.51

              	
                190.37

              	
                94.52

              	
                67.12

              	
                136.49

              	
                72.38

              	
                254.10

              	
                164.92

              	
                342.33

              	
                8,796.56

              	
                1,536.63

              	
                401.17

              	
                243.67

              	
                248.87

              	
                702.91

              	
                649.30

              	
                356.54

              	
                299.65

              	
                211.35

              	
                237.65

              	
                83.24

              	
                73.70

              
	
                04

              	
                877.99

              	
                175.55

              	
                87.56

              	
                63.92

              	
                127.39

              	
                68.47

              	
                235.93

              	
                153.75

              	
                318.93

              	
                8,571.86

              	
                1,495.59

              	
                394.00

              	
                254.46

              	
                252.62

              	
                694.02

              	
                635.24

              	
                342.17

              	
                311.96

              	
                223.04

              	
                215.68

              	
                94.67

              	
                84.86

              
	
                05

              	
                919.98

              	
                183.43

              	
                91.15

              	
                64.87

              	
                131.62

              	
                69.93

              	
                245.33

              	
                159.49

              	
                331.03

              	
                9,248.02

              	
                1,615.41

              	
                420.86

              	
                252.27

              	
                258.55

              	
                735.80

              	
                681.19

              	
                332.63

              	
                321.24

              	
                227.10

              	
                214.59

              	
                83.91

              	
                74.53

              
	
                06

              	
                839.91

              	
                168.14

              	
                84.80

              	
                67.94

              	
                131.59

              	
                75.16

              	
                230.12

              	
                151.25

              	
                309.66

              	
                8,536.50

              	
                1,494.29

              	
                393.28

              	
                262.75

              	
                284.04

              	
                746.59

              	
                653.76

              	
                319.38

              	
                288.23

              	
                202.46

              	
                201.26

              	
                73.23

              	
                64.45

              
	
                 

                07

              	
                 

                894.05

              	
                 

                178.57

              	
                 

                89.54

              	
                 

                68.64

              	
                 

                132.32

              	
                 

                72.39

              	
                 

                240.41

              	
                 

                156.74

              	
                 

                324.62

              	
                 

                8,976.52

              	
                 

                1,573.98

              	
                 

                414.04

              	
                 

                264.97

              	
                 

                264.82

              	
                 

                733.66

              	
                 

                674.72

              	
                 

                312.78

              	
                 

                296.22

              	
                 

                210.25

              	
                 

                203.20

              	
                 

                84.13

              	
                 

                74.97

              
	
                 

                08

              	
                 

                785.53

              	
                 

                156.86

              	
                 

                78.13

              	
                 

                56.61

              	
                 

                113.39

              	
                 

                60.74

              	
                 

                210.44

              	
                 

                136.92

              	
                 

                284.23

              	
                 

                8,247.94

              	
                 

                1,440.21

              	
                 

                376.25

              	
                 

                229.28

              	
                 

                234.06

              	
                 

                659.32

              	
                 

                608.59

              	
                 

                313.20

              	
                 

                297.40

              	
                 

                210.20

              	
                 

                191.91

              	
                 

                77.95

              	
                 

                69.13

              
	
                 

                09

              	
                 

                850.66

              	
                 

                169.57

              	
                 

                84.85

              	
                 

                61.30

              	
                 

                122.72

              	
                 

                65.71

              	
                 

                227.14

              	
                 

                147.75

              	
                 

                306.35

              	
                 

                9,123.68

              	
                 

                1,599.07

              	
                 

                417.49

              	
                 

                252.14

              	
                 

                258.39

              	
                 

                734.15

              	
                 

                680.34

              	
                 

                292.37

              	
                 

                328.87

              	
                 

                233.20

              	
                 

                183.12

              	
                 

                87.73

              	
                 

                78.10

              
	
                 

                10

              	
                 

                854.19

              	
                 

                170.88

              	
                 

                86.07

              	
                 

                67.92

              	
                 

                128.34

              	
                 

                71.08

              	
                 

                231.04

              	
                 

                150.99

              	
                 

                312.37

              	
                 

                11,134.68

              	
                 

                1,955.19

              	
                 

                510.16

              	
                 

                308.82

              	
                 

                316.57

              	
                 

                900.47

              	
                 

                834.79

              	
                 

                319.50

              	
                 

                346.90

              	
                 

                244.42

              	
                 

                209.21

              	
                 

                87.86

              	
                 

                77.46

              
	
                 

                11

              	
                 

                1,110.68

              	
                 

                220.95

              	
                 

                110.34

              	
                 

                81.84

              	
                 

                161.42

              	
                 

                87.06

              	
                 

                295.39

              	
                 

                192.02

              	
                 

                397.48

              	
                 

                12,135.44

              	
                 

                2,122.05

              	
                 

                554.29

              	
                 

                334.42

              	
                 

                342.80

              	
                 

                971.48

              	
                 

                898.72

              	
                 

                457.65

              	
                 

                426.65

              	
                 

                300.08

              	
                 

                276.22

              	
                 

                118.35

              	
                 

                104.11

              
	
                TABLE
                  5

              
	
                 

                General
                  + Mental Health Rates + Dental Services: Effect from July 1, 05
                  - Dec 31,
                  05

              	
                 

                Effect
                  from Jan 1, 06 - June 30, 06

              
	 	
                 

                TANF

              	
                 

                SSI-NO
                  MEDICARE

              	
                 

                SSI-B

              	
                 

                 

                SSI-AB

              	
                 

                SSI-B

              	
                SSI-AB

              
	
                 

                Area

              	
                 

                THMO+2MO

              	
                 

                3MO-

                 

                11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE

                 

                (14-20)

                 

                 

              	
                 

                AGE

                 

                (21-54)

                 

              	
                 

                AGE

                 

                (55+)

              	
                 

                THMO+

                 

                2MO

              	
                 

                3MO-11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE
                  

                 

                (14-20)

              	
                 

                AGE

                 

                (21-54)

              	
                 

                AGE

                 

                (55+)

              	 	
                 

                AGE
                  

                 

                (65-)

              	
                 

                AGE
                  

                 

                (65+)

              	 	
                 

                AGE
                  (65-)

              	
                 

                AGE
                  (65+)

              
	 	 	 	 	 	
                 

                Female

              	
                 

                Male

              	
                 

                Female

              	
                 

                Male

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                 

                01
                  

              	
                 

                856.86

              	
                 

                169.65

              	
                 

                87.27

              	
                 

                69.60

              	
                 

                134.50

              	
                 

                76.14

              	
                 

                228.68

              	
                 

                149.10

              	
                 

                304.00

              	
                 

                8,379.21

              	
                 

                1,456.22

              	
                 

                386.89

              	
                 

                267.23

              	
                 

                287.97

              	
                 

                733.35

              	
                 

                632.69

              	
                 

                367.59

              	
                 

                332.50

              	
                 

                236.48

              	
                 

                221.72

              	
                 

                95.35

              	
                 

                84.90

              
	
                02
                  

              	
                856.87

              	
                169.66

              	
                88.05

              	
                74.62

              	
                134.77

              	
                76.41

              	
                227.58

              	
                148.00

              	
                 

                303.40

              	
                8,379.20

              	
                1,456.21

              	
                391.42

              	
                282.22

              	
                267.93

              	
                691.54

              	
                622.02

              	
                380.89

              	
                329.35

              	
                233.33

              	
                235.02

              	
                92.20

              	
                81.75

              
	
                 

                03
                  

              	
                956.51

              	
                190.38

              	
                 

                97.82

              	
                 

                73.70

              	
                 

                143.65

              	
                 

                78.21

              	
                 

                257.43

              	
                 

                167.67

              	
                344.37

              	
                8,796.56

              	
                1,536.66

              	
                 

                404.61

              	
                 

                249.14

              	
                 

                253.82

              	
                 

                705.61

              	
                 

                651.12

              	
                357.90

              	
                 

                301.80

              	
                 

                212.17

              	
                 

                239.01

              	
                 

                85.39

              	
                 

                74.52

              
	
                04

              	
                877.99

              	
                175.56

              	
                89.87

              	
                68.54

              	
                132.41

              	
                72.56

              	
                239.16

              	
                156.42

              	
                 

                320.90

              	
                8,571.86

              	
                1,495.61

              	
                396.55

              	
                258.50

              	
                256.28

              	
                696.70

              	
                637.05

              	
                343.38

              	
                314.28

              	
                223.92

              	
                216.89

              	
                96.99

              	
                85.74

              
	
                 

                05
                  

              	
                919.99

              	
                183.45

              	
                 

                94.96

              	
                 

                72.47

              	
                 

                139.89

              	
                 

                76.66

              	
                 

                255.49

              	
                 

                167.89

              	
                337.25

              	
                9,248.02

              	
                1,615.45

              	
                 

                425.71

              	
                 

                259.96

              	
                 

                265.51

              	
                 

                741.31

              	
                 

                684.91

              	
                337.53

              	
                 

                327.49

              	
                 

                229.49

              	
                 

                219.49

              	
                 

                90.16

              	
                 

                76.92

              
	
                06

              	
                839.91

              	
                168.15

              	
                87.92

              	
                74.13

              	
                138.34

              	
                80.65

              	
                236.22

              	
                156.29

              	
                 

                313.39

              	
                8,536.50

              	
                1,494.32

              	
                396.83

              	
                268.38

              	
                289.13

              	
                751.60

              	
                657.14

              	
                321.97

              	
                293.12

              	
                204.33

              	
                203.85

              	
                78.12

              	
                66.32

              
	
                07
                  

              	
                 

                894.05

              	
                 

                178.58

              	
                92.25

              	
                74.05

              	
                138.20

              	
                77.18

              	
                246.16

              	
                161.49

              	
                328.14

              	
                 

                8,976.52

              	
                 

                1,574.01

              	
                417.39

              	
                270.28

              	
                269.62

              	
                737.28

              	
                677.16

              	
                 

                313.96

              	
                299.51

              	
                211.51

              	
                204.38

              	
                87.42

              	
                76.32

              
	
                08
                  

              	
                 

                785.53

              	
                 

                156.87

              	
                80.86

              	
                62.06

              	
                119.32

              	
                65.58

              	
                216.18

              	
                141.66

              	
                287.75

              	
                 

                8,247.94

              	
                 

                1,440.23

              	
                379.11

              	
                233.83

              	
                238.17

              	
                663.94

              	
                611.71

              	
                 

                315.66

              	
                301.33

              	
                211.71

              	
                194.37

              	
                81.88

              	
                70.64

              
	
                 

                09
                  

              	
                 

                850.67

              	
                 

                169.59

              	
                 

                88.02

              	
                 

                68.42

              	
                 

                130.47

              	
                 

                72.02

              	
                230.86

              	
                 

                150.82

              	
                308.62

              	
                 

                9,123.68

              	
                 

                1,599.09

              	
                 

                420.67

              	
                 

                257.19

              	
                 

                262.96

              	
                 

                737.05

              	
                 

                682.30

              	
                 

                293.64

              	
                 

                331.52

              	
                 

                234.21

              	
                 

                184.39

              	
                 

                90.38

              	
                 

                79.11

              
	
                 

                10
                  

              	
                 

                854.19

              	
                 

                170.89

              	
                 

                89.25.
                  

              	
                 

                74.28

              	
                 

                135.25

              	
                 

                76.71

              	
                 

                234.07

              	
                 

                153.50

              	
                 

                314.22

              	
                 

                11,134.68

              	
                 

                1,955.22

              	
                 

                514.10

              	
                 

                315.08

              	
                 

                322.23

              	
                 

                903.47

              	
                 

                836.82

              	
                 

                320.96

              	
                 

                349.89

              	
                 

                245.57

              	
                 

                210.67

              	
                 

                90.85

              	
                 

                78.61

              
	
                 

                11

              	
                 

                1,110.69

              	
                 

                220.97

              	
                 

                114.29

              	
                 

                89.72

              	
                 

                170.00

              	
                 

                94.05

              	
                 

                298.44

              	
                 

                194.54

              	
                 

                399.34

              	
                 

                12,135.44

              	
                 

                2,122.08

              	
                 

                558.67

              	
                 

                341.36

              	
                 

                349.08

              	
                 

                974.53

              	
                 

                900.78

              	
                 

                459.09

              	
                 

                429.66

              	
                 

                301.23

              	
                 

                277.66

              	
                 

                121.36

              	
                 

                105.26

              
	
                TABLE
                  6

                 

                194.54

              	 
	
                 

                General
                  + Dental Rates: Effect from July 1, 05 - Dec 31, 05 Effect from
                  Jan 1, 06
                  - June 30, 06

              	
                 

                Effect
                  from Jan 1, 06 - June 30, 06

              
	 	
                 

                TANF

              	
                 

                SSI-NO
                  MEDICARE

              	
                 

                SSI-B

              	
                 

                 

                SSI-AB

              	
                 

                SSI-B

              	
                SSI-AB

              
	
                 

                Area

              	
                 

                THMO+2MO

              	
                 

                3MO-11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE

                 

                (14-20)

                 

                 

              	
                 

                AGE

                 

                (21-54)

                 

              	
                 

                AGE

                 

                (55+)

              	
                 

                THMO+

                 

                2MO

              	
                 

                3MO-11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE

                 

                (14-20)

              	
                 

                AGE

                 

                (21-54)

              	
                 

                AGE

                 

                (55+)

              	 	
                 

                AGE

                 

                (65-)

              	
                 

                AGE

                 

                (65+)

              	 	
                 

                AGE
                  (65-)

              	
                 

                AGE
                  (65+)

              
	 	 	 	 	 	
                Female

              	
                Male

              	
                Female

              	
                Male

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                 

                01
                  

              	
                 

                859.91

              	
                 

                170.77

              	
                 

                85.48

              	
                 

                64.88

              	
                 

                130.31

              	
                 

                72.41

              	
                 

                230.32

              	
                 

                149.96

              	
                 

                306.37

              	
                 

                8,391.88

              	
                 

                1,468.03

              	
                 

                391.80

              	
                 

                265.39

              	
                 

                288.24

              	
                 

                746.90

              	
                 

                642.34

              	
                 

                381.78

              	
                 

                348.03

              	
                 

                242.95

              	
                 

                235.91

              	
                 

                110.88

              	
                 

                91.37

              
	
                02
                  

              	
                859.92

              	
                170.78

              	
                86.26

              	
                69.90

              	
                130.58

              	
                72.68

              	
                229.22

              	
                148.86

              	
                305.77

              	
                8,391.87

              	
                1,468.02

              	
                396.33

              	
                280.38

              	
                268.20

              	
                705.09

              	
                631.67

              	
                395.08

              	
                344.88

              	
                239.80

              	
                249.21

              	
                107.73

              	
                88.22

              
	
                03
                  

              	
                959.99

              	
                191.67

              	
                95.55

              	
                67.87

              	
                138.37

              	
                73.55

              	
                257.15

              	
                166.87

              	
                345.75

              	
                8,811.88

              	
                1,550.93

              	
                410.11

              	
                246.22

              	
                253.50

              	
                720.86

              	
                662.01

              	
                367.18

              	
                323.05

              	
                221.05

              	
                248.29

              	
                106.64

              	
                83.40

              
	
                04
                  

              	
                880.33

              	
                176.42

              	
                88.25

              	
                64.42

              	
                128.66

              	
                69.26

              	
                237.98

              	
                155.06

              	
                321.23

              	
                8,588.74

              	
                1,511.35

              	
                403.87

              	
                257.27

              	
                257.73

              	
                713.81

              	
                649.26

              	
                348.76

              	
                335.40

              	
                232.76

              	
                222.27

              	
                118.11

              	
                94.58

              
	
                05
                  

              	
                922.11

              	
                184.22

              	
                91.78

              	
                65.33

              	
                132.77

              	
                70.65

              	
                247.20

              	
                160.68

              	
                333.12

              	
                9,257.24

              	
                1,624.01

              	
                426.24

              	
                253.80

              	
                261.34

              	
                746.60

              	
                688.84

              	
                338.19

              	
                335.39

              	
                232.97

              	
                220.15

              	
                98.06

              	
                80.40

              
	
                06
                  

              	
                942.33

              	
                169.04

              	
                85.51

              	
                68.45

              	
                132.90

              	
                75.98

              	
                232.24

              	
                152.60

              	
                312.04

              	
                8,546.98

              	
                1,504.07

              	
                399.40

              	
                264.50

              	
                287.21

              	
                758.86

              	
                662.45

              	
                324.14

              	
                302.75

              	
                208.48

              	
                206.02

              	
                87.75

              	
                70.47

              
	
                07
                  

              	
                895.76

              	
                179.21

              	
                90.05

              	
                69.01

              	
                133.25

              	
                72.97

              	
                241.91

              	
                157.70

              	
                326.30

              	
                8,987.85

              	
                1,584.56

              	
                420.65

              	
                266.86

              	
                268.24

              	
                746.93

              	
                684.12

              	
                318.23

              	
                313.37

              	
                217.36

              	
                208.65

              	
                101.28

              	
                82.08

              
	
                08
                  

              	
                788.65

              	
                158.02

              	
                79.05

              	
                57.28

              	
                115.07

              	
                61.79

              	
                213.16

              	
                138.66

              	
                287.30

              	
                8,259.68

              	
                1,451.17

              	
                383.10

              	
                231.23

              	
                237.61

              	
                673.07

              	
                618.33

              	
                323.00

              	
                312.89

              	
                216.62

              	
                201.71

              	
                96.44

              	
                75.55

              
	
                09
                  

              	
                853.55

              	
                170.65

              	
                85.31

              	
                61.92

              	
                124.27

              	
                66.68

              	
                229.66

              	
                149.36

              	
                309.18

              	
                9,136.01

              	
                1,610.59424.70

              	
                424.70

              	
                254.19

              	
                262.11

              	
                748.60

              	
                690.58

              	
                296.78

              	
                348.11

              	
                241.18

              	
                187.53

              	
                106.97

              	
                86.08

              
	
                10
                  

              	
                856.38

              	
                171.69

              	
                86.72

              	
                68.39

              	
                129.53

              	
                71.82

              	
                232.96

              	
                152.21

              	
                314.52

              	
                11,151.25

              	
                1,970.65

              	
                519.83

              	
                311.58

              	
                321.58

              	
                919.86

              	
                848.54

              	
                325.77

              	
                369.08

              	
                253.62

              	
                215.48

              	
                110.04

              	
                86.66

              
	
                11
                  

              	
                1,112.09

              	
                221.48

              	
                110.76

              	
                82.14

              	
                162.18

              	
                87.53

              	
                296.62

              	
                192.80

              	
                398.87

              	
                12,145.45

              	
                2,131.39

              	
                560.13

              	
                336.09

              	
                345.82

              	
                983.20

              	
                907.03

              	
                462.31

              	
                439.76

              	
                305.52

              	
                280.88

              	
                131.46

              	
                109.55

              

      

      

      AHCA
        Contract No. FA522, Attachment VIII-A, Page 2 of 3

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      

      
        	
                TABLE
                  7

              
	
                 

                General
                  + Dental + Transportation Rates: Effect from July 1, 05 - Dec 31,
                  05

                 

                Effect
                  from July 1, 05 - Dec 31, 05

              	
                 

                Effect
                  from Jan 1, 06 - June 30, 06

              
	 	
                 

                TANF

              	
                 

                SSI-NO
                  MEDICARE

              	
                 

                SSI-B

              	
                 

                SSI-AB

              	
                 

                SSI-B

              	
                 

                SSI-AB

              
	
                 

                Area

              	
                 

                THMO

                 

                +2MO

              	
                 

                3MO-

                 

                11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE

                 

                (14-20)

                 

                 

              	
                 

                AGE

                 

                (21-54)

                 

              	
                 

                AGE

                 

                (55+)

              	
                 

                BTHMO+2MO

              	
                 

                3MO-11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE
                  (14-20)

              	
                 

                AGE
                  (21-54)

              	
                 

                AGE

                 

                (55+)

              	 	
                 

                AGE
                  

                 

                (65-)

              	
                 

                AGE
                  (65+)

              	 	
                 

                AGE
                  (65-)

              	
                 

                AGE
                  (65+)

              
	 	 	 	 	 	
                Female

              	
                Male
                  

              	
                Female

              	
                Male

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                 

                01

              	
                 

                859.91

              	
                 

                170.77

              	
                 

                86.58

              	
                 

                58.47

              	
                 

                123.65

              	
                 

                64.67

              	
                 

                227.19

              	
                 

                146.65

              	
                 

                303.27

              	
                 

                8,391.86

              	
                 

                1,468.03

              	
                 

                383.21

              	
                 

                198.76

              	
                 

                218.41

              	
                 

                653.06

              	
                 

                610.23

              	
                 

                374.15

              	
                 

                332.40

              	
                 

                226.73

              	
                 

                228.28

              	
                 

                95.25

              	
                 

                75.15

              
	
                02

              	
                859.90

              	
                170.77

              	
                86.58

              	
                58.47

              	
                123.65

              	
                64.67

              	
                227.19

              	
                146.65

              	
                303.27

              	
                8,391.86

              	
                 

                1,468.03

              	
                 

                383.21

              	
                 

                198.76

              	
                 

                218.41

              	
                 

                653.06

              	
                 

                610.23

              	
                 

                374.15

              	
                 

                332.40

              	
                 

                226.73

              	
                 

                228.28

              	
                 

                95.25

              	
                 

                75.15

              
	
                03

              	
                959.98

              	
                191.67

              	
                97.80

              	
                66.99

              	
                139.86

              	
                73.71

              	
                259.13

              	
                168.27

              	
                346.41

              	
                8,811.87

              	
                1,550.95

              	
                406.61

              	
                213.66

              	
                234.73

              	
                699.86

              	
                653.92

              	
                359.95

              	
                317.66

              	
                214.33

              	
                241.06

              	
                101.25

              	
                76.68

              
	
                04

              	
                880.32

              	
                176.42

              	
                89.37

              	
                60.59

              	
                127.26

              	
                66.93

              	
                239.68

              	
                163.20

              	
                321.63

              	
                8,588.73

              	
                1,511.36

              	
                396.41

              	
                206.42

              	
                227.16

              	
                682.29

              	
                636.76

              	
                341.39

              	
                320.25

              	
                216.17

              	
                214.90

              	
                102.96

              	
                77.99

              
	
                05

              	
                922.11

              	
                184.23

              	
                94.57

              	
                65.74

              	
                135.57

              	
                71.91

              	
                256.05

              	
                167.77

              	
                338.00

              	
                9,257.23

              	
                1,624.04

              	
                424.57

              	
                225.76

              	
                246.02

              	
                729.85

              	
                683.25

              	
                338.22

              	
                331.84

              	
                225.56

              	
                220.18

              	
                94.51

              	
                72.99

              
	
                06

              	
                842.31

              	
                169.03

              	
                86.65

              	
                59.94

              	
                124.05

              	
                65.87

              	
                233.16

              	
                152.46

              	
                311.13

              	
                8,546.96

              	
                1,504.08

              	
                393.27

              	
                208.50

              	
                228.20

              	
                680.79

              	
                637.03

              	
                325.49

              	
                303.34

              	
                206.05

              	
                207.37

              	
                88.34

              	
                68.04

              
	
                 

                07

              	
                895.75

              	
                179.21

              	
                91.02

              	
                 

                62.11

              	
                 

                129.78

              	
                 

                68.41

              	
                 

                245.43

              	
                 

                160.22

              	
                 

                327.54

              	
                 

                8,987.84

              	
                 

                1,584.58

              	
                 

                414.47

              	
                 

                219.94

              	
                 

                240.47

              	
                 

                718.01

              	
                 

                672.95

              	
                 

                315.53

              	
                 

                304.95

              	
                 

                206.91

              	
                 

                205.95

              	
                 

                92.86

              	
                 

                71.63

              
	
                 

                08

              	
                788.64

              	
                158.02

              	
                80.77

              	
                 

                55.56

              	
                 

                115.55

              	
                 

                61.18

              	
                 

                217.60

              	
                 

                142.10

              	
                 

                289.49

              	
                 

                8,259.67

              	
                 

                1,451.18

              	
                 

                379.25

              	
                 

                199.01

              	
                 

                218.79

              	
                 

                654.78

              	
                 

                611.86

              	
                 

                318.85

              	
                 

                308.05

              	
                 

                209.36

              	
                 

                197.56

              	
                 

                88.60

              	
                 

                68.29

              
	
                 

                09

              	
                853.55

              	
                170.66

              	
                87.75

              	
                 

                61.02

              	
                 

                125.93

              	
                 

                66.90

              	
                 

                231.93

              	
                 

                150.98

              	
                 

                309.93

              	
                 

                9,136.00

              	
                 

                1,610.60

              	
                 

                421.31

              	
                 

                223.21

              	
                 

                244.21

              	
                 

                729.05

              	
                 

                683.15

              	
                 

                294.37

              	
                 

                339.14

              	
                 

                230.57

              	
                 

                185.12

              	
                 

                98.00

              	
                 

                75.47

              
	
                 

                10

              	
                856.36

              	
                171.68

              	
                87.94

              	
                 

                60.90

              	
                 

                125.92

              	
                 

                66.93

              	
                 

                223.48

              	
                 

                152.21

              	
                 

                313.80

              	
                 

                11,151.24

              	
                 

                1,970.67

              	
                 

                515.75

              	
                 

                273.87

              	
                 

                299.82

              	
                 

                895.47

              	
                 

                839.11

              	
                 

                323.92

              	
                 

                366.20

              	
                 

                248.90

              	
                 

                213.63

              	
                 

                107.16

              	
                 

                81.94

              
	
                 

                11

              	
                1,112.09

              	
                221.49

              	
                112.91

              	
                 

                77.26

              	
                 

                161.07

              	
                 

                84.83

              	
                 

                297.35

              	
                 

                193.00

              	
                 

                398.36

              	
                 

                12,145.44

              	
                 

                2,131.41

              	
                 

                555.46

              	
                 

                293.43

              	
                 

                321.17

              	
                 

                955.35

              	
                 

                896.16

              	
                 

                456.78

              	
                 

                436.97

              	
                 

                300.87

              	
                 

                275.35

              	
                 

                128.67

              	
                 

                104.90

              
	
                TABLE
                  8

              
	
                 

                General
                  + Mental Health + Transportation + Dental Rates: Effect from July
                  1, 05 -
                  Dec 31, 05

              	
                 

                Effect
                  from Jan 1, 06 - June 30, 06

              
	 	
                 

                TANF

              	
                 

                SSI-NO
                  MEDICARE

              	
                 

                SSI-B

              	
                 

                 

                SSI-AB

              	
                 

                SSI-B

              	
                SSI-AB

              
	
                 

                Area

              	
                 

                THMO+2MO

              	
                 

                3MO-

                 

                11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE

                 

                (14-20)

                 

                 

              	
                 

                AGE

                 

                (21-54)

                 

              	
                 

                AGE

                 

                (55+)

              	
                 

                THMO+

                 

                2MO

              	
                 

                3MO-11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE
                  

                 

                (14-20)

              	
                 

                AGE

                 

                (21-54)

              	
                 

                AGE

                 

                (55+)

              	 	
                 

                AGE
                  

                 

                (65-)

              	
                 

                AGE
                  

                 

                (65+)

              	 	
                 

                AGE
                  (65-)

              	
                 

                AGE
                  (65+)

              
	 	 	 	 	 	
                 

                Female

              	
                 

                Male

              	
                 

                Female

              	
                 

                Male

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                 

                01
                  

              	
                 

                859.91

              	
                 

                170.78

              	
                 

                88.17

              	
                 

                70.25

              	
                 

                136.15

              	
                 

                77.17

              	
                 

                231.34

              	
                 

                150.80

              	
                 

                306.99

              	
                 

                8,391.88

              	
                 

                1,468.05

              	
                 

                394.29

              	
                 

                269.34

              	
                 

                291.81

              	
                 

                748.19

              	
                 

                643.21

              	
                 

                381.88

              	
                 

                348.99

              	
                 

                243.32

              	
                 

                236.01

              	
                 

                111.84

              	
                 

                91.74

              
	
                02
                  

              	
                859.92

              	
                170.79

              	
                88.95

              	
                75.27

              	
                136.42

              	
                77.44

              	
                230.24

              	
                149.70

              	
                 

                306.39

              	
                8,391.87

              	
                 

                1,468.04

              	
                398.83

              	
                284.33

              	
                271.77

              	
                706.38

              	
                632.54

              	
                395.18

              	
                345.84

              	
                240.17

              	
                249.31

              	
                108.69

              	
                88.59

              
	
                 

                03
                  

              	
                959.99

              	
                191.68

              	
                 

                98.85

              	
                 

                74.45

              	
                 

                145.53

              	
                 

                79.38

              	
                 

                260.48

              	
                 

                169.62

              	
                347.79

              	
                8,811.88

              	
                1,550.96

              	
                 

                413.55

              	
                 

                251.69

              	
                 

                258.45

              	
                 

                723.56

              	
                663.83

              	
                 

                368.54

              	
                 

                325.20

              	
                 

                221.87

              	
                 

                249.65

              	
                 

                108.79

              	
                 

                84.22

              
	
                04

              	
                880.33

              	
                176.43

              	
                90.56

              	
                69.04

              	
                133.68

              	
                73.35

              	
                241.21

              	
                157.73

              	
                 

                323.20

              	
                8,588.74

              	
                1,511.37

              	
                406.42

              	
                261.31

              	
                261.39

              	
                716.49

              	
                651.07

              	
                349.97

              	
                337.72

              	
                233.64

              	
                223.48

              	
                120.13

              	
                95.46

              
	
                 

                05
                  

              	
                922.12

              	
                184.24

              	
                 

                95.59

              	
                 

                72.93

              	
                 

                141.04

              	
                 

                77.38

              	
                 

                257.36

              	
                 

                169.08

              	
                339.34

              	
                9,257.25

              	
                1,624.05

              	
                 

                431.09

              	
                 

                261.49

              	
                 

                268.30

              	
                 

                752.11

              	
                 

                692.56

              	
                343.09

              	
                 

                341.64

              	
                 

                235.36

              	
                 

                225.05

              	
                 

                104.31

              	
                 

                82.79

              
	
                06

              	
                842.33

              	
                169.05

              	
                88.63

              	
                74.64

              	
                139.65

              	
                81.47

              	
                238.34

              	
                157.64

              	
                 

                315.77

              	
                8,546.98

              	
                1,504.10

              	
                402.95

              	
                270.13

              	
                292.30

              	
                763.87

              	
                665.83

              	
                326.73

              	
                307.64

              	
                210.35

              	
                208.61

              	
                92.64

              	
                72.34

              
	
                07
                  

              	
                895.76

              	
                179.22

              	
                92.76

              	
                74.42

              	
                139.13

              	
                77.76

              	
                274.66

              	
                162.45

              	
                329.82

              	
                 

                8,987.85

              	
                 

                1,584.59

              	
                424.00

              	
                272.17

              	
                273.04

              	
                750.55

              	
                626.56

              	
                 

                319.41

              	
                316.66

              	
                218.62

              	
                209.83

              	
                104.57

              	
                83.34

              
	
                08
                  

              	
                788.65

              	
                158.03

              	
                81.78

              	
                62.73

              	
                121.00

              	
                66.63

              	
                218.90

              	
                143.10

              	
                290.82

              	
                 

                8,259.68

              	
                 

                1,451.19

              	
                385.96

              	
                235.78

              	
                241.72

              	
                677.69

              	
                621.45

              	
                 

                325.46

              	
                316.82

              	
                218.13

              	
                204.17

              	
                97.37

              	
                77.06

              
	
                 

                09
                  

              	
                853.56

              	
                170.67

              	
                 

                88.88

              	
                 

                69.04

              	
                 

                132.02

              	
                 

                72.99

              	
                233.38

              	
                 

                152.43

              	
                311.45

              	
                 

                9,136.01

              	
                 

                1,610.61

              	
                 

                427.88

              	
                 

                259.24

              	
                 

                266.68

              	
                 

                751.50

              	
                 

                692.54

              	
                 

                298.05

              	
                 

                350.76

              	
                 

                242.19

              	
                 

                188.80

              	
                 

                109.62

              	
                 

                87.09

              
	
                 

                10
                  

              	
                856.38

              	
                171.70

              	
                 

                89.90

              	
                 

                74.75

              	
                 

                136.44

              	
                 

                77.45

              	
                 

                235.99

              	
                 

                154.72

              	
                 

                319.37

              	
                 

                11,151.25

              	
                 

                1,970.68

              	
                 

                523.77

              	
                 

                317.84

              	
                 

                327.24

              	
                 

                922.86

              	
                 

                850.57

              	
                 

                327.23

              	
                 

                372.23

              	
                 

                254.77

              	
                 

                216.94

              	
                 

                113.03

              	
                 

                87.81

              
	
                 

                11

              	
                1,112.10

              	
                221.50

              	
                 

                114.71

              	
                 

                90.02

              	
                 

                170.76

              	
                 

                94.52

              	
                 

                299.67

              	
                 

                195.32

              	
                 

                400.73

              	
                 

                12,145.45

              	
                 

                2,131.42

              	
                 

                564.51

              	
                 

                343.03

              	
                 

                352.10

              	
                 

                986.25

              	
                 

                909.09

              	
                 

                463.75

              	
                 

                442.77

              	
                 

                306.67

              	
                 

                282.32

              	
                 

                134.47

              	
                 

                110.70

              

      

      

      

      

      

      

      

      

      

      

      

      

      

      

      

      

      

      

      

      

      

      

      

      

      

      

      

      

      AHCA
        Contract No. FA522, Attachment VIII-A, Page 3 of 3

       

      

      

        

        
           

          1

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00095-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00095-of-00352.parquet"}]]