Document:

exv10w27w2w2

 

Exhibit 10.27.2.2

			
	 	 	 
	Amerigroup Florida, Inc. 

d/b/a Amerigroup Community Care
	 	Medicaid HMO Contract

AHCA CONTRACT NO. FAR005

AMENDMENT NO. 5

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

1. Effective September 1, 2007, Attachment I, Scope of Services, is hereby amended to include
Exhibit 5-B, attached hereto and made a part of the Contract. All references in the Contract to
Exhibit 5-A, shall hereinafter instead refer to Exhibit 5-B.

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

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

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

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

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

	 	 	 	 	 	 	 	 
	AMERIGROUP FLORIDA, INC. 

D/B/A/ AMERIGROUP COMMUNITY CARE
	 	STATE OF FLORIDA, AGENCY FOR

HEALTH CARE ADMINISTRATION	 
	 
	 	 	 	 	 	 	 
	SIGNED

	 	 	SIGNED	 	 
	 
	 	 	 	 	 	 	 
	BY: 
	/S/ William McHugh 	 	BY: 	 	 	 
	 	 
	 	 	 	 
	 	NAME:
	William McHugh 	 	 	NAME: 	Andrew C. Agwunobi, M.D 	 
	 	TITLE:
	 CEO 	 	 	TITLE:	 Secretary 	 
	 	DATE:

	 11-30-07 	 	 	DATE:	 	 

List of attachments included as part of this Amendment:

	 	 	 	 	 
	Specify	 	Letter/	 	 
	Type	 	Number	 	Description
	Exhibit

	 	5-B
	 	Capitation Rates SSI Medicare Part B Only and SSI Medicare Parts A and B
Enrollees for All Medicaid Reform Counties (1 Page)

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AHCA Contract No. FAR005, Amendment No. 5, Page 1 of 1

 

 

EXHIBIT 5 — B

CAPTITATION RATES

SSI MEDICARE PART B ONLY

AND

SSI MEDICARE PARTS A AND B ENROLLEES

FOR ALL MEDICAID REFORM COUNTIES

Table 4

***REDACTED***

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AHCA Contract No. FAR005, Exhibit 5-B, Page 1 of 1exv10w27w2w3

 

Exhibit 10.27.2.3

			
	Amerigroup Florida, Inc. 

d/b/a Amerigroup Community Care
	 	Medicaid Reform HMO Contract

AHCA CONTRACT NO. FAR005

AMENDMENT NO. 7

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

	1.	 	Standard Contract, Section II, Item A, Contract Amount, the first sentence is hereby revised
to now read as follows:
	 
	 	 	To pay for contracted services according to the conditions of Attachment I in an amount not
to exceed $98,825,203.00 (an increase of $32,071.00), subject to availability of funds.
	 
	2.	 	Attachment I, Scope of Services, Section C, Method of Payment, Item 1, General, the first
paragraph is hereby revised to now read as follows:
	 
	 	 	Notwithstanding the payment amounts which may be computed with the rate tables specified in
Tables 2 thru 8, the sum of total capitation payments under this Contract shall not exceed
the total Contract amount of $98,825,203.00 (an increase of $32,071.00).
	 
	3.	 	Attachment I, Scope of Services, is hereby amended to include Exhibits 3-B, 5-C, 6-C, and
9-B, attached hereto and made a part of the Contract. All references in the Contract to
Exhibits 3-A, 5-B, 6-B, and 9-A, shall hereinafter instead refer to Exhibits 3-B, 5-C, 6-C,
and 9-B.
	 
	4.	 	This Amendment shall have an effective date of January 1, 2008, or the date on which other
parties execute the Amendment which ever is later.

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

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

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

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

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AHCA Contract No. FAR005, Amendment No. 7, Page 1 of 2

 

 

			
	Amerigroup Florida, Inc. 

d/b/a Amerigroup Community Care
	 	Medicaid Reform HMO Contract

     IN WITNESS WHEREOF, the parties hereto have caused this seven (7) page amendment (which
includes all attachments hereto) to be executed by their officials thereunto duly authorized.

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION

	 	 	 	 	 	 	 	 	 	 	 
	SIGNED BY:

	 	/s/ THOMAS WILFONG
 

	 	  
	 	NAME:
	 	Andrew C. Agwunobi, M.D.
	 	 
	NAME:

	 	THOMAS WILFONG
	 	 	 	TITLE:
	 	Secretary	 	 
	TITLE:

	 	COO
	 	 	 	DATE:	 	__________ 	 	 
	DATE:

	 	12/25/2007	 	 	 	 	 	 	 	 

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

	 	 	 	 	 
	 	 	Letter/	 	 
	Specify Type	 	Number	 	Description
	Exhibit

	 	3-B
	 	Comprehensive and Catastrophic Component Capitation Rates (2 Pages)
	 
	 	 	 	 
	Exhibit

	 	5-C
	 	Capitation Rates SSI Medicare Part B Only and SSI Medicare Parts A & B
Enrollees for All Medicaid Reform Counties (1 Page)
	 
	 	 	 	 
	Exhibit

	 	6-C
	 	Capitation Rates for HIV/AIDS Populations for Each Medicaid Reform

County (1 Page)
	 
	 	 	 	 
	Exhibit

Services

(1 Page)

	 	9-B
	 	Kick Payment Amounts for Covered Obstetrical Delivery

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AHCA Contract No. FAR005, Amendment No. 7, Page 2 of 2

 

 

EXHIBIT 3-B

COMPREHENSIVE COMPONENT AND CATASTROPHIC COMPONENT
 CAPITATION

RATES

Jan 1, 2008

TABLE 2

	 	 	 
	Area: 10

	 	County: Broward

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

***REDACTED***

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AHCA Contract No. FAR3, Exhibit 6-C, Page 1 of 1

 

 

EXHIBIT 3-B

COMPREHENSIVE COMPONENT AND CATASTROPHIC COMPONENT
 CAPITATION

RATES

Jan 1, 2008

TABLE 2

	 	 	 
	Area: 4

	 	County: Duval, Baker, Clay, Nassau

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

***REDACTED***

REMAINDER OF PAGE INTENTIONALLY LEFT BLANK

AHCA Contract No. FAR4, Exhibit 6-C, Page 1 of 1

 

 

EXHIBIT 5-C

CAPITATION RATES

SSI MEDICARE PART B ONLY

AND

SSI MEDICARE PARTS A AND B ENROLLEES

FOR ALL MEDICAID REFORM COUNTIES

TABLE 4

	 	 	 
	Area: 10

	 	County: Broward

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

***REDACTED***

	 	 	 
	Area: 4

	 	County: Duval, Baker, Clay, and Nassau

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

***REDACTED***

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AHCA Contract No. FAR5, Exhibit 6-C, Page 1 of 1

 

 

EXHIBIT 6-C

CAPITATION RATES FOR HIV/AIDS POPULATIONS FOR
 EACH

MEDICAID REFORM COUNTY

TABLE 5

	 	 	 
	Area: 10

	 	County: Broward

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

***REDACTED***

	 	 	 
	Area: 4

	 	County: Duval, Baker, Clay, and Nassau

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

***REDACTED***

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AHCA Contract No. FAR6, Exhibit 6-C, Page 1 of 1

 

 

EXHIBIT 9-B

KICK PAYMENT AMOUNTS FOR COVERED
 OBSTETRICAL

DELIVERY SERVICES

TABLE 8

	 	 	 
	Area: 10

	 	County: Broward

***REDACTED***

	 	 	 
	Area: 04

	 	County: Duval, Baker, Clay, Nassau

***REDACTED***

AHCA Contract No. FAR005, Exhibit 9-B, Page 1 of 1exv10w33w3

 

Exhibit 10.33.3

GEORGIA DEPARTMET OF

COMMUNITY HEALTH

	 	 	 	 	 
	 
	 	 	 	2 Peachtree Street, NW
	Rhonda M. Meadows, MD Commissioner
	 	Sonny Perdue, Governor
	 	Atlanta, GA 30303-3159
	 
	 	 	 	www.dch.georgia.gov
	 

January 29, 2008

Kathleen Cistola

Director, Regulatory Compliance

Amerigroup Corporation

4425 Corporation Lane

Virginia Beach, VA 23462

RE: Contract # 0652, Amendment #2

Dear Ms. Cistola:

Enclosed is an executed original Amendment # 2 between Amerigroup Corporation and the
Georgia Department of Community Health (DCH) for Provision of Services to Georgia
Healthy Families. The Amendment is for your file.

Please contact me at 404-651-9189, if you have any questions regarding the
enclosed Amendment.

Enclosure (1)

	 	 	 	 	 
	 	Sincereley,

 	 
	 	/S/ Clyde White
 	 
	 	Clyde White 	 
	 	Director of Contracts 	 
	 

Equal Opportunity Employer

Page 1 of 6

 

AMENDMENT #2 TO CONTRACT NO. 0652 BETWEEN

GEORGIA DEPARTMENT OF COMMUNITY HEALTH AND

AMERIGROUP GEORGIA MANAGED CARE COMPANY, INC.

     This Amendment is between the Georgia Department of Community Health (hereinafter
referred to as “DCH” or the “Department”) and Amerigroup Georgia Managed Care Company, Inc.
(hereinafter referred to as “Contractor”) and is made effective this 28th
day of January, 2008 (hereinafter referred to as the “Effective Date”). Other than the
changes modifications and additions specifically articulated in this Amendment #2 to
Contract # 0652, RFP#41900-001-0000000027, the original Contract shall remain in effect and
binding on and against DCH and Contractor. Unless expressly modified or added in this
Amendment #2, the terms and conditions of the original Contract are expressly incorporated
into this Amendment #2 as if completely restated herein.

     WHEREAS, DCH and Contractor executed a contract for the provision of services to
Georgia Healthy Families; and,

     WHEREAS, pursuant to Section 4.8.17.1, Network Changes, DCH and Contractor have agreed
that Contractor shall notify DCH within seven (7) Business Days of any significant changes
to the Provider network or, if applicable, to any Subcontractor’s Provider Network; and,

     WHEREAS, pursuant to Section 32.0, Amendments in Writing, DCH and Contractor desire to
amend the above-referenced Contract by adding additional funding as set forth below.

     NOW THEREFORE, for and in consideration of the mutual promises of the Parties, the
terms, provisions and conditions of this Amendment and other good and valuable
consideration, the sufficiency of which is hereby acknowledged, DCH and Contractor hereby
agree as follows:

	I.	 	To delete the current Attachment H, Capitation Payment, in its entirety and replace
with the new Attachment H, Capitation Payment, contained at Exhibit 1 to this
Amendment.
	 
	II.	 	To amend the Contract by adding Section 4.8.17.6, which reads as follows:

	 	4.8.17.6	 	If the Contractor fails to comply with the provisions of Section
4.8.17.1, the per member per month capitation rate, used by DCH to
compensate the Contractor, will be reduced by 3.1% for the remaining
term of the Contract, including any renewals.

Amendment #2

Contract #0652

Page 2 of 6

 

	III.	 	To amend the Contract by adding Section 4.8.17.7, which reads as follows:

	 	4.8.17.7	 	DCH and Contractor acknowledge that any failure by Contractor to comply
with the terms of Section 4.8.17.1 would constitute a material failure to
implement the terms of the Contract and RFP. If liquidated damages are
assessed against the Contractor due to its failure to comply with Section
4.8.17.1, the damages will be assessed in accordance with Section 23.2.1
(Category 1).

	IV.	 	DCH and Contractor agree that they have assumed an obligation to perform the covenants,
agreements, duties and obligations of the Contract, as modified and amended herein, and agree
to abide by all the provisions, terms and conditions contained in the Contract as modified and
amended.
	 
	V.	 	This Amendment shall be binding and inure to the benefit of the parties hereto, their heirs,
representatives, successors and assigns. Whenever the provisions of this Amendment and the
Contract are in conflict, the provisions of this Amendment shall take precedence and control.
	 
	VI.	 	It is understood by the Parties hereto that, if any part, term, or provision of this Amendment or this entire Amendment
is held to be illegal or in conflict with any law of this State, then DCH, at its sole option, may enforce the remaining
unaffected portions or provisions of this Amendment or of the Contract and the rights and obligations of the parties
shall be construed and enforced as if the Contract or Amendment did not contain the particular part, term or provision
held to be invalid.
	 
	VII.	 	This Amendment shall become effective as stated herein and shall remain effective for so long as the Contract is in
effect.
	 
	VIII.	 	This Amendment shall be construed in accordance with the laws of the State of Georgia.
	 
	IX.	 	All other terms and conditions contained in the Contract and any amendment thereto, not
amended by this Amendment, shall remain in full force and effect.

— SIGNATURES ON THE FOLLOWING PAGE —

 Amendment #2

Contract #0652

Page 3 of 6

 

     IN WITNESS WHEREOF, DCH and Contractor, through their authorized officers and
agents, have caused this Amendment to be executed on their behalf as of the date
indicated.

	 	 	 	 	 
	GEOR A DEPARTMENT OF COMMUNITY HEALTH

 	 
	/S/ Dr. Rhonda M. Medows, M.D. 	 	1/28/08 
	Dr. Rhonda M. Medows, M.D.          	 	Date 
	Commissioner 	 	 
	 

	 	 	 	 	 
	AMERIGROUP GEORGIA MANAGED CARE COMPANY, INC.

 	 
	BY:  	/S/ Melvin Lindsey 	 	11-14-07 
	*Signature                  	 	Date  
	 
	 	 	 
	/s/ Melvin Lindsey
 	 	 
	Please Print/Type Name Here 	 	 
	 
	 	 	 
	ATTEST: /S/ Stanley F. Baldwin
 	 	 
	**  Signature 	 	 
	 	 	 
	Vice President and Secretary
 	 	AFFIX CORPORATE SEAL HERE
 (Corporations without a seal, attach a Certificate of Corporate
Resolution) 
	TITLE	 
	 	 

 

			
	*	 	Must be President, Vice President, CEO or Other Authorized Officer

	 
	**	 	Must be Corporate Secretary

 Amendment #2

Contract #0652

Page 4 of 6

 

CONFIDENTIAL — NOT FOR CIRCULATION

ATTACHMENT H

Attachment H is a table displaying the contracted rates by rate cell for each contracted region.
These rates will be the basis for calculating capitation payments in each contracted Region.

(The table is displayed on the following page.)

 Amendment #2

Contract #0652

Page 5 of 6

 

Georgia Department of Community Health

Fiscal Year 2008 CMO Rates

***REDACTED***

Page 6 of 6

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