Document:

Exhibit 10.103

 

[SEAL]

 

Business Associate Amendment

 

This Amendment (“Amendment”)
supplements and is made a part of the CaliforniaCare Medical Services Agreement
(“Agreement”) dated November 1, 1999 by and between Blue Cross of California
(“Health Plan”) and Professional Care IPA (“Provider”).

 

A.    Health Plan and Provider are parties to the Agreement pursuant to which
Provider provides a service to, or performs a function on behalf of, Health
Plan and, in connection therewith, uses or discloses Protected Health
Information (“PHI”) that is subject to protection under the Health Insurance
Portability and Accountability Act of 1996 (“HIPAA”) and certain regulations
found at 45 CFR Parts 160 through 164 (“HIPAA Regulations”);

 

B.    Health Plan is a Covered Entity as that term is defined in the HIPAA
Regulations.  Provider creates or
receives PHI from or on behalf of Health Plan and is, therefore, a Business
Associate, as defined in the HIPAA Regulations;

 

C.    Pursuant to the HIPAA Regulations, Provider, as a Business Associate of
Health Plan, must agree in writing to certain mandatory provisions regarding
the use and disclosure of PHI; and

 

D.    The purpose of this Amendment is to satisfy the Business Associate
contract requirements as set forth at § 164.504(e) of the HIPAA Regulations, as
they may be amended from time-to-time.

 

NOW, THEREFORE, in
consideration of the mutual promises and covenants contained herein, the
parties agree as follows:

 

1.     Definitions.  Unless otherwise provided in
this Amendment, capitalized terms have the same meaning as set forth in the
HIPAA Regulations.

 

2.     Scope of Use and Disclosure of PHI.  Except as otherwise limited
in this Amendment:

a.     Provider shall use and disclose PHI solely to provide the services, or
perform the functions, described in the Agreement, provided that such use or
disclosure would not violate the HIPAA Regulations if so used or disclosed by
Health Plan.

b.     Provider may use or disclose PHI for the proper management and
administration of Provider or to provide Data Aggregation services to Health
Plan.

 

3.     Obligations of Provider.  In
connection with its use and disclosure of PHI, Provider shall:

a.     Not use or disclose PHI other than as permitted or required by the
Agreement or as Required By Law.

 

1

 

b.     Use reasonable and appropriate safeguards to prevent use or disclosure
of the PHI other than as provided for by this Amendment.

c.     Mitigate, to the extent practicable, any harmful effect that is known
to Provider of a use or disclosure of PHI by Provider in violation of the
requirements of this Amendment.

d.     Report to Health Plan any use or disclosure of the PHI not provided for
by this Amendment of which Provider becomes aware.

e.     Require contractors, subcontractors, and/or agents to whom Provider
provides PHI created or received by Provider on behalf of Health Plan to agree
to the same restrictions and conditions that apply to Provider with respect to
such PHI under this Amendment.

f.      Provide access, within seven
(7) days following Health Plan’s request, to PHI in a Designated Record Set, to Health Plan in order to meet the requirements
under § 164.524 of the HIPAA Regulations. 
If Health Plan and Provider mutually agree, Provider may provide such
access directly to Individual, provided that such access is provided to the
Individual in the time-frames set forth in § 164.524 of the HIPAA Regulations.

g.     Promptly make any amendment(s) to PHI in a Designated Record Set that
the Health Plan directs or agrees to pursuant to § 164.526 of the HIPAA
Regulations at the request of Health Plan.

h.     Make internal practices, books, and records, including, but not limited
to, policies and procedures, relating to the use and disclosure of PHI created
or received by Provider on behalf of Health Plan available to the Secretary,
and to Health Plan, if requested, in a time and manner designated by the
Secretary, for purposes of the Secretary determining Health Plan’s compliance
with the HIPAA Regulations.

i.      Maintain for a period of six (6) years an accounting of all disclosures
of PHI that are required to be maintained under § 164.528 of the HIPAA
Regulations.  Such accounting will
include the date of the disclosure, the name of the recipient, a description of
PHI disclosed and the purpose of the disclosure.

j.      Provide within seven (7) days following Health Plan’s request,
information collected in accordance with Section 3.i. of this Amendment, to
permit Health Plan to respond to a request by an Individual for an accounting
of disclosures of PHI in accordance with § 164.528 of the HIPAA
Regulations.  If Health Plan and
Provider mutually agree, Provider may provide such accounting directly to
Individual, provided that such accounting is provided to the Individual in the
time-frames set forth in § 164.528 of the HIPAA Regulations.

k.     Make reasonable efforts to implement any restriction of the use or
disclosure of PHI that Health Plan has agreed to under Section 4.c. of this
Amendment.

 

4.     Obligations of Health Plan. 
Health Plan shall:

a.     Provide Provider with the notice of privacy practices that Health Plan
furnishes to Individuals in accordance with § 164.520 of the HIPAA Regulations.

 

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b.     Promptly notify Provider of any changes in, or revocation of, permission
by Individual to use or disclose PHI, to the extent that such changes may
affect Provider’s use or disclosure of PHI.

c.     Promptly notify Provider of any restriction to the use or disclosure of
PHI that Health Plan has agreed to in accordance with § 164.522 of the HIPAA
Regulations, to the extent that such restriction may affect Provider’s use or
disclosure of PHI.

d.     Not request Provider to use or disclose PHI in any manner that would
not be permissible under the HIPAA Regulations if so used or disclosed by
Health Plan, unless such use or disclosure is necessary for the purposes of
Data Aggregation or management and administrative activities of Provider under
the Agreement.

e.     Pay Provider five cents ($0.05) per page for all records and documents that
Provider is obligated to provide to Health Plan under the terms of this
Amendment.

 

5.     Termination for Breach.  Upon
Health Plan’s knowledge of a material breach of the terms of this Amendment by
Provider, Health Plan shall, in accordance with the notification requirement
and cure period set forth in the Agreement, provide an opportunity for Provider
to cure the breach or end the violation. 
Health Plan may terminate the Agreement if Provider does not cure the breach
or end the violation within the cure period set forth in the Agreement.

 

6.     Future Confidentiality of PHI. 
Upon the expiration or earlier termination of the Agreement, for any
reason, Provider shall return or destroy all PHI received from Health Plan, or
created or received by Provider on behalf of Health Plan that Provider still
maintains and retain no copies of such PHI; provided that if such return or
destruction of PHI is infeasible, Provider shall provide to Health Plan
notification of the conditions that make return or destruction infeasible and
shall extend the protections of this Amendment to such PHI and limit further
uses and disclosures of such PHI to those purposes that make the return or
destruction infeasible, for so long as Provider maintains such PHI.

 

7.     Amendment.  The parties agree to take
such action to amend this Amendment from time-to-time as is necessary for
Health Plan to comply with the requirements of HIPAA and the HIPAA Regulations.

 

8.     Survival.  The respective rights and
obligations of Provider under Section 6 of this Amendment shall survive the
termination of the Agreement.

 

9.     Interpretation.  Any
ambiguity in this Amendment shall be resolved to permit Health Plan to comply
with the HIPAA Regulations.

 

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10.   Conflict of Terms. 
Whenever the terms of the Agreement and this Amendment are in conflict,
the terms of this Amendment shall control.

 

11.   Other Terms Remain in Force. 
Except as expressly modified by the terms of this Amendment, all of the
terms and conditions set forth in the Agreement shall remain in full force and
effect.

 

Effective
Date.  This Amendment shall be effective on April
14, 2003.

 

IN WITNESS WHEREOF, the
parties have executed this Amendment as of the date(s) set forth below.

 

 

	
  Professional
  Care IPA

  	
  BLUE
  CROSS OF CALIFORNIA

  
	
   

  	
   

  
	
  /s/ Rick Shinto

  	
   

  	
  /s/ Barry Ford

  
	
  Signature

  	
  Signature

  
	
   

  	
   

  
	
  Rick Shinto, MD

  	
   

  	
  BARRY FORD

  
	
  Print Name

  	
  Print Name

  
	
   

  	
   

  
	
  Medical Director

  	
   

  	
  V.P. Network
  Services

  
	
  Title

  	
  Title

  
	
   

  	
   

  
	
  4/28/03

  	
   

  	
  5/8/03

  
	
  Date

  	
  Date

  
				

 

4Exhibit 10.104

 

ASSIGNMENT
AND CONSENT TO ASSIGNMENT

 

This Assignment and Consent to Assignment (hereinafter “Assignment”) is
entered into effective October 1, 2003 by and between Professional Care IPA
Medical Group, Inc (hereinafter “ASSIGNOR”), Prospect Medical Group, Inc
(hereinafter “ASSIGNEE”) and Blue Cross of California and its Affiliates
(hereinafter “BLUE CROSS”).

 

RECITALS

 

A.            ASSIGNOR and BLUE CROSS have entered into that
certain CaliforniaCare Medical Services Agreement effective November 1, 1999 (hereinafter the
“Agreement”);

 

B.            ASSIGNOR will be acquired by ASSIGNEE
effective October 1, 2003 and ASSIGNEE will be the surviving entity;

 

C.            ASSIGNOR desires to assign its rights and
delegate its duties under the Agreement to ASSIGNEE;

 

D.            ASSIGNEE desires to accept the rights and
assume the obligations of ASSIGNOR under the Agreement;

 

E.             Under the Agreement ASSIGNOR may assign the
Agreement subject to the consent of BLUE CROSS;

 

F.             BLUE CROSS desires to agree to the assignment
of the Agreement subject to the conditions precedent stated herein;

 

THEREFORE, THE PARTIES AGREE AS FOLLOWS:

 

I.              ASSIGNMENT OF RIGHTS

 

1.1           ASSIGNOR hereby assigns to ASSIGNEE all right, title, and interest in
and to the Agreement between ASSIGNOR and BLUE CROSS, a copy of which is
attached hereto, said assignment to be effective as of October 1, 2003.

 

1.2           ASSIGNEE hereby accepts assignment of the Agreement, effective as of
October 1, 2003 subject to all of the
terms and conditions thereof.

 

1.3           It is specifically understood and agreed that ASSIGNOR’s assignment to
ASSIGNEE of its rights under the Agreement includes the right to receive any
and all payments or consideration due thereunder from BLUE CROSS,
notwithstanding the fact that the right to payments or consideration may have
accrued prior to the effective date of this assignment and delegation.

 

II.            DELEGATION OF DUTIES

 

2.1           ASSIGNOR hereby delegates to ASSIGNEE all of
its duties and obligations of performance under the Agreement between ASSIGNOR
and BLUE CROSS.

 

2.2           ASSIGNEE hereby accepts delegation of and agrees to assume full
responsibility for performance of all duties and obligations under the
Agreement to the same extent as if it had been an original party thereto.

 

2.3           It is specifically understood and agreed that ASSIGNOR’s delegation to
and ASSIGNEE’s acceptance of its duties and obligations under the Agreement
includes all duties and obligations of ASSIGNOR, notwithstanding the fact that
said duties and obligations may have accrued prior to the effective date of this
assignment and delegation.

 

1

 

III.           CONSENT

 

3.1           BLUE CROSS hereby consents to the assignment and delegation of the
Agreement from ASSIGNOR to ASSIGNEE to be effective as of October 1, 2003.

 

IV.           MISCELLANEOUS

 

4.1           Further assignment of rights and duties under the Agreement shall occur
only upon the mutual written agreement of ASSIGNEE and BLUE CROSS.

 

4.2           It is understood and agreed that
endorsements or amendments of the Agreement, or both, may be necessary as a
result of this Assignment and the parties hereto agree to meet and confer in
good faith and to execute any and all endorsements or amendments of the
Agreement, or both, which may be necessary to effectuate the intentions of the
parties hereto.

 

IN WITNESS WHEREOF, the parties hereto have executed this Assignment on
the date and year first written above

 

	
  BLUE CROSS

  	
  ASSIGNOR

  
	
   

  	
   

  
	
   

  	
   

  
	
  /s/ Barry Ford

  	
   

  	
  /s/ Shinto

  
	
  Signature

  	
  Signature

  
	
   

  	
   

  
	
  BARRY FORD

  	
   

  	
  SHINTO

  
	
  Print Name

  	
  Print Name

  
	
   

  	
   

  
	
  V.P. Network Services

  	
   

  	
   

  
	
  Title

  	
  Title

  
	
   

  	
   

  
	
  10.1.03

  	
   

  	
  9/23/03

  
	
  Date

  	
  Date

  
	
   

  	
   

  
	
   

  	
   

  
	
  ASSIGNEE

  	
   

  
	
   

  	
   

  
	
  /s/ Peter G. Goll

  	
   

  	
   

  
	
  Signature

  	
   

  
	
   

  	
   

  
	
  Peter G. Goll

  	
   

  	
   

  
	
  Print Name

  	
   

  
	
   

  	
   

  
	
  Senior Vice President

  	
   

  	
   

  
	
  Title

  	
   

  
	
   

  	
   

  
	
  9-9-03

  	
   

  	
   

  
	
  Date

  	
   

  

 

2

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