Document:

Exhibit 10.1

EXHIBIT
10.1

	 	 	 

	

	 	ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM ADMINISTRATION

DIVISION OF BUSINESS AND FINANCE 
SECTION A: CONTRACT

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 

	1.

	 	 	AMENDMENT
	2.  	 CONTRACT
	 	 	3.	 	 	EFFECTIVE DATE OF
	4.  	 PROGRAM
	 

	 	 	NUMBER:
	 	NO.:
	 	 	 	 	 	AMENDMENT:
	 	 
	 

	 	 	11	 	 	YH09-0001-07
	 	 	 	 	 	October 1, 2009
	 	DHCM — ACUTE

5. CONTRACTOR’S NAME AND ADDRESS:

VHS Phoenix Health Plan, LLC

7878 N. 16th St., Suite 105

Phoenix, AZ 85020

6. PURPOSE OF AMENDMENT: To amend Section B, Capitation Rates, to allow for
payment of retroactive
rural hospital inpatient reimbursement, effective October 1, 2009 through September 30,
2010.

7. THE CONTRACT REFERENCED ABOVE FOLLOWS

ADD to Section B, CAPITATION RATES after first subparagraph add the following
language:

“The Contractor will be paid the attached supplemental payment amounts to increase rural
hospital inpatient reimbursement. The supplemental payment amounts are allocated to the
appropriate risk groups based on historical utilization. AHCCCS requires that the Contractor
them make one-time payments to each rural hospital as prescribed on the attached schedule,
pursuant to A.R.S. § 36-2905.02, to increase inpatient reimbursement to these small rural
hospitals.

The Contractor shall make the prescribed payments to the rural hospitals 15 days from receipt
of the funds and submit proof of payment to the rural hospitals to the Assistant Director of
the Division of Health Care Management 30 days from receipt of the funds.

The regular per member per month capitation rates for the period of October 1, 2009 through
September 30, 2010, are not impacted by this amendment.

	 	 	 

	NOTE: Please sign, date, and return executed file by E-Mail to:  

	 	Mark Held at
Mark.Held@azahcccs.gov

Sr. Procurement Specialist

AHCCCS Contracts and Purchasing 

  and Stewart McKenzie at

Stewart.McKenzie@azahcccs.gov

8. EXCEPT AS PROVIDED FOR HEREIN, ALL TERMS AND CONDITIONS OF THE ORIGINAL
CONTRACT NOT HERETOFORE CHANGED AND/OR AMENDED REMAIN UNCHANGED AND
IN FULL EFFECT.

IN WITNESS WHEREOF THE PARTIES HERETO SIGN THEIR NAMES IN AGREEMENT

	 	 	 

	9. SIGNATURE OF AUTHORIZED
REPRESENTATIVE:

 /s/ Nancy Novick

	 	10. SIGNATURE OF AHCCCSA CONTRACTING
OFFICER:
 

/s/ Michael Veit
	TYPED NAME: NANCY NOVICK

	 	TYPED NAME: MICHAEL VEIT
	TITLE: CHIEF EXECUTIVE OFFICER

	 	TITLE: CONTRACTS & PURCHASING
ADMINISTRATOR
	 
	 	 
	DATE: 10/25/10

	 	DATE: OCT 8 2010

 

 

 

ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM

ACUTE SUPPLEMENTAL PAYMENT SUMMARY — Rural

Phoenix Health Plan

CYE 2010

Supplemental Payment Related To:

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	TANF	 	 	TANF	 	 	SSI	 	 	SSI	 	 	 	 	 	 	Total	 
	Supplemental Payment:	 	<1, M/F	 	 	14-44, F	 	 	w/ Med	 	 	w/o Med	 	 	Non-MED	 	 	Payment	 
	4 Apache/Coconino/Mohave/Navajo
	 	$	267,525.62	 	 	$	472,205.45	 	 	$	172,081.51	 	 	$	245,114.28	 	 	$	425,972.26	 	 	$	1,582,899.12	 
	6 Yavapai
	 	$	186,186.55	 	 	$	346,670.58	 	 	$	216,277.31	 	 	$	201,388.65	 	 	$	524,237.38	 	 	$	1,474,760.47	 
	8 Gila/Pinal
	 	$	154,685.29	 	 	$	363,596.63	 	 	$	88,861.76	 	 	$	180,701.26	 	 	$	282,100.83	 	 	$	1,069,945.77	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	$	4,127,605.36	 

Two percent Premium tax is included in the Supplemental Capitation Payments.

Payments to the hospitals stated without Premium Tax.

	 	 	 	 	 
	Phoenix Health Plan	 	Payment	 
	Benson Hospital
	 	$	—	 
	Carondelet Holy Cross
	 	$	—	 
	Cobre Valley Community Hospital
	 	$	350,517.10	 
	Copper Queen Community Hospital
	 	$	—	 
	La Paz Regional Hospital
	 	$	35,698.91	 
	Little Colorado Medical Center
	 	$	292,963.73	 
	Mount Graham Regional Medical Center
	 	$	—	 
	Summit Healthcare Regional Medical Center
	 	$	368,712.22	 
	Northern Cochise Community Hospital
	 	$	—	 
	Page Hospital
	 	$	106,490.49	 
	Payson Regional Medical Center
	 	$	929,435.40	 
	Sage Memorial Hospital
	 	$	—	 
	Sierra Vista Regional Health
	 	$	—	 
	Southeastern Az Medical Center
	 	$	—	 
	Valley View Medical Center
	 	$	431,388.66	 
	Verde Valley Medical Center
	 	$	1,256,708.34	 
	White Mountain Regional Medical Center
	 	$	25,037.78	 
	Wickenburg Regional Health Center
	 	$	9,066.14	 
	YRMC East
	 	$	239,034.48	 
	 
	 	 	 
	Total Payments
	 	$	4,045,053.25	 
	Premium Tax
	 	$	82,552.11	 
	Total with Premium Tax
	 	$	4,127,605.36Exhibit 10.2

EXHIBIT 10.2

	 	 	 
	

	 	ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM ADMINISTRATION

DIVISION OF BUSINESS AND FINANCE

SECTION A: CONTRACT

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	1 .

	 	AMENDMENT
	 	 	2.	 	 	CONTRACT
	 	 	3.	 	 	EFFECTIVE DATE OF
	 	 	4.	 	 	PROGRAM
	 

	 	NUMBER:
	 	 	 	 	 	NO.:
	 	 	 	 	 	AMENDMENT:	 	 	 	 	 	 
	 

	 	12
	 	 	 	 	 	YH09-0001-07
	 	 	 	 	 	October 1, 2009
	 	 	 	 	 	DHCM — ACUTE

5. CONTRACTOR’S NAME AND ADDRESS:

VHS Phoenix Health Plan, LLC

7878 N. 16th St., Suite 105

Phoenix, AZ 85020

6. PURPOSE OF AMENDMENT: To amend Section B, Capitation Rates, effective October 1, 2009
through
September 30, 2010.

7. THE CONTRACT REFERENCED ABOVE FOLLOWS

To amend Section B, Capitation Rates, effective October 1, 2009 through September 30, 2010.

NOTE: Please sign, date, and return executed file by E-Mail to:  Mark Held at Mark.Held@azahcccs.gov

Sr. Procurement Specialist

AHCCCS Contracts and Purchasing

and Stewart McKenzie at

Stewart.McKenzie@azahcccs.gov

8. EXCEPT AS PROVIDED FOR HEREIN, ALL TERMS AND CONDITIONS OF THE ORIGINAL
CONTRACT NOT HERETOFORE CHANGED AND/OR AMENDED REMAIN UNCHANGED AND
IN FULL EFFECT.

IN WITNESS WHEREOF THE PARTIES HERETO SIGN THEIR NAMES IN AGREEMENT

	 	 	 
	9. SIGNATURE OF AUTHORIZED
REPRESENTATIVE:

	 	10. SIGNATURE OF AHCCCSA CONTRACTING
OFFICER:
	 
	/s/ Nancy Novick
	 	/s/ Michael Veit
	TYPED NAME: NANCY NOVICK

	 	TYPED NAME: MICHAEL VEIT
	TITLE: CHIEF EXECUTIVE OFFICER

	 	TITLE: CONTRACTS & PURCHASING ADMINISTRATOR
	 
	 	 
	DATE: 11/5/10

	 	DATE: OCT 26 2010

 

 

 

ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM

REVISED CAPITATION RATE SUMMARY — ACUTE RATES

Phoenix Health Plan

10/1/09-9/30/10

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	TANF	 	 	TANF	 	 	TANF	 	 	TANF	 	 	TANF	 	 	SSI	 	 	SSI	 	 	 	 
	Title XIX and KidsCare Rates 1:	 	<1, M/F	 	 	1-13, M/F	 	 	14-44, F	 	 	14-44, M	 	 	45+, M/F	 	 	w/ Med	 	 	w/o Med	 	 	Non-MED	 
	4 Apache/Coconino/Mohave/Navajo
	 	$	461.60	 	 	$	111.96	 	 	$	267.24	 	 	$	150.93	 	 	$	395.92	 	 	$	153.53	 	 	$	717.85	 	 	$	482.71	 
	6 Yavapai
	 	$	509.93	 	 	$	118.24	 	 	$	282.23	 	 	$	184.89	 	 	$	442.03	 	 	$	145.89	 	 	$	786.83	 	 	$	602.35	 
	8 Gila/Pinal
	 	$	562.01	 	 	$	108.28	 	 	$	256.33	 	 	$	176.97	 	 	$	372.20	 	 	$	136.42	 	 	$	756.92	 	 	$	476.08	 
	10 Pima
	 	$	461.72	 	 	$	94.10	 	 	$	216.44	 	 	$	114.09	 	 	$	359.91	 	 	$	120.13	 	 	$	792.17	 	 	$	410.62	 
	12 Maricopa
	 	$	492.87	 	 	$	116.46	 	 	$	240.02	 	 	$	150.56	 	 	$	401.09	 	 	$	150.47	 	 	$	690.42	 	 	$	544.37	 

	 	 	 
	1.	 	Rates have been adjusted for $35,000 Reinsurance DeductibleExhibit 10.3

EXHIBIT 10.3

	 	 	 
	

	 	ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM ADMINISTRATION

DIVISION OF BUSINESS AND FINANCE
SECTION A: CONTRACT

	 	 	 	 	 	 	 
	1. AMENDMENT 

    NUMBER:

	2.   	CONTRACT 

NO.:
	3.   	EFFECTIVE DATE OF 

AMENDMENT:
	4.   	PROGRAM
	13

	 	YH09-0001-07
	 	October 1, 2010
	 	DHCM — ACUTE

5. CONTRACTOR’S NAME AND ADDRESS:

VHS Phoenix Health Plan, LLC

7878 N. 16th St., Suite 105

Phoenix, AZ 85020

6. PURPOSE OF AMENDMENT: To amend Section B, Capitation Rates, effective October 1, 2010
through September 30, 2011.

7. THE CONTRACT REFERENCED ABOVE FOLLOWS

To amend Section B, Capitation Rates, effective October 1, 2010 through September 30, 2011.

NOTE: Please sign, date, and return executed file by E-Mail to: Mark Held at
Mark.Held@azahcccs.gov

	 	 	 
	 

	 	Sr. Procurement Specialist
	 

	 	AHCCCS Contracts and Purchasing
	 

	 	and Stewart McKenzie at
	 

	 	Stewart.McKenzie@azahcccs.gov

8. EXCEPT AS PROVIDED FOR HEREIN, ALL TERMS AND CONDITIONS OF THE ORIGINAL
CONTRACT NOT HERETOFORE CHANGED AND/OR AMENDED REMAIN UNCHANGED AND
IN FULL EFFECT.

IN WITNESS WHEREOF THE PARTIES HERETO SIGN THEIR NAMES IN AGREEMENT

	 	 	 	 	 
	9. SIGNATURE OF AUTHORIZED
REPRESENTATIVE:

	 	 	 	10. SIGNATURE OF AHCCCSA
CONTRACTING OFFICER:
	 
	 	 	 	 
	/s/ Nancy Novick

	 	 	 	/s/ Michael Veit
	 

	 	 	 	 
	TYPED NAME: NANCY NOVICK

	 	 	 	TYPED NAME: MICHAEL VEIT
	TITLE: CHIEF EXECUTIVE OFFICER

	 	 	 	TITLE: CONTRACTS & PURCHASING ADMINISTRATOR
	 
	 	 	 	 
	DATE: 1-17-11

	 	 	 	DATE: JANUARY 5, 2011

 

 

 

ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM

REVISED CAPITATION RATE SUMMARY — CYE 11 ACUTE RATES RISK ADJUSTED WITH 100% OF CYE 10 FACTORS

Phoenix Health Plan

10/1/10-9/30/11

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	TANF	 	 	TANF	 	 	TANF	 	 	TANF	 	 	TANF	 	 	SSI	 	 	SSI	 	 	 	 
	Title XIX and KidsCare Rates 1:	 	<1, M/F	 	 	1-13, M/F	 	 	14-44, F	 	 	14-44, M	 	 	45+, M/F	 	 	w/ Med	 	 	w/o Med	 	 	Non-MED	 
	4
	 	Apache/Coconino/Mohave/Navajo	 	$	540.94	 	 	$	114.08	 	 	$	275.59	 	 	$	166.92	 	 	$	377.04	 	 	$	107.68	 	 	$	816.24	 	 	$	460.93	 
	6
	 	Yavapai	 	$	553.24	 	 	$	113.10	 	 	$	284.63	 	 	$	179.62	 	 	$	415.24	 	 	$	133.51	 	 	$	875.73	 	 	$	566.85	 
	8
	 	Gila/Pinal	 	$	480.12	 	 	$	109.26	 	 	$	265.40	 	 	$	176.95	 	 	$	380.79	 	 	$	134.34	 	 	$	889.56	 	 	$	466.00	 
	10
	 	Pima	 	$	542.07	 	 	$	89.71	 	 	$	210.86	 	 	$	122.17	 	 	$	325.24	 	 	$	102.09	 	 	$	814.38	 	 	$	390.01	 
	12
	 	Maricopa	 	$	501.68	 	 	$	113.20	 	 	$	244.34	 	 	$	158.81	 	 	$	415.73	 	 	$	146.66	 	 	$	730.40	 	 	$	489.53	 

	 	 	 
	1.	 	Rates have been adjusted for $35,000 Reinsurance Deductible

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