Document:

EX-10.22.7

	 
	AMENDMENT OF SOLICITATION / MODIFICATION OF CONTRACT

	1. Contract Number
Page of Pages
POHC-2002-D-0003
1
2
2. Amendment/Modification Number
3. Effective Date
4. Requisition/Purchase Request No.
5. Solicitation Caption
 M00017
March 1, 2005
DC Healthy Families Program
6. Issued by:

	Code
5BJPW
7. Administered by (If other than line 6)
Office of Contracting and Procurement
Human Care Services Commodity Group
441 4th Street, NW., Suite 700 South
Washington, DC 20001
Department of Health
Medical Assistance Administration
825 North Capitol Street, NE. 4th floor
Washington, DC 20002
8. Name and Address of Contractor (No., street, city, county, state and zip code)
9A. Amendment of Solicitation No.
 AmeriGroup Maryland, Inc.
dba AmeriGroup District of Columbia.
750 First Street NE, Suite 1120
Washington, DC 20004
Phone: 202-218-4901 Fax: 202-783-8207
9B. Dated (See Item 11)
X
10A. Modification of Contract/Order No.
POHC-2002-D-0003
10B. Dated (See Item 13)
August 1, 2002
DUNSCode
 TIN
11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS
The above numbered solicitation is amended as set forth in item 14. The hour and date specified for receipt of Offers is extended. is not extended.
Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

	(a) By completing Items 8 and 15, and returning __________ copies of the amendment: (b) By acknowledging receipt of this amendment on each copy of the offer
submitted; or (c) By separate letter or fax which includes a reference to the solicitation and amendment number. FAILURE OF YOUR ACKNOWLEDGMENT TO BE
RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If by virtue of this
amendment you desire to change an offer already submitted, such may be made by letter or fax, provided each letter or fax makes reference to the
solicitation and this amendment, and is received prior to the opening hour and date specified.
12. Accounting and Appropriation Data (If Required)
13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,
IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14
A. This change order is issued pursuant to (Specify Authority):

	The changes set forth in Item 14 are made in the contract/order no. in item 10A.
B. The above numbered contract/order is modified to reflect the administrative changes (such as changes in paying office, appropriation data etc.) set forth
in item 14, pursuant to the authority of 27 DCMR, Chapter 36, Section 3601.2.
X
C. This supplemental agreement is entered into pursuant to authority of: 27 DCMR Section 3601.2
The Changes Clause and mutual agreement of the parties.
D. Other (Specify type of modification and authority)
E. IMPORTANT: Contractor  is not  is required to sign this document and return ________ copies to the issuing office.
14. Description of Amendment/Modification (Organized by UCF Section headings, including solicitation/contract subject matter where feasible.)
The contract referenced in block 10 is hereby modified to reflect changes associated with the addition of an expansion population as follows:

	A. ADD to Section B, Section B.6.1.9 as shown on page 2 (Attachment 1).
B. ADD to Section B, Section B.3.4 as shown on page 2 (Attachment 1).
C. CHANGE C.1.1.1 to read as shown on page 2 (Attachment 1).
D. ADD to Section C.1.2, the Applicable Documents as cited on page 2
(Attachment 2).
E. ADD as B.6.2 the accepted rates for the expansion population as shown on the following page 2.
ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED.
Except as provided herein, all terms and conditions of the document is referenced in Item 9A or 10A remain unchanged and in full force and effect.
15A. Name and Title of Signer (Type or print)
16A. Name of Contracting Officer
Janice Parker Watson
15B. Name of Contractor
15C. Date Signed
16B. District of Columbia
16C. Date Signed
(Signature)
(Signature of Contracting Officer)

CONTRACT MODIFICATION FOR DCHFP
PAGE 2

POHC-2002-D-0003/M00017

 ATTACHMENT 1

ADD:

B.3.4. Enrollment estimates are not guaranteed.

	 	 	 
	ADD:

	 	

	 
	 	 
	B.6.1.9 50-64 years of age childless adults

	 
	 	 
	ADD:

	 	

	 
	 	 
	B.6.2Rates for expansion population are as follows:

	 
	 	 
	0001AI

	 	50-64 years of age childless adults$890.00 per member per month
	 
	 	 
	CHANGE C.1.1.1 to read as follows:

	 	

	 
	 	 
	C.1.1.1DCHFP: The DCHFP program is a capitated program that consists of an array of comprehensive

	 
	 	 
	healthcare and mental health services. Services will be provided to approximately 100,000 primarily

	 
	 	 
	low-income pregnant women, children and adults who are enrolled in the DCHFP managed care program on a

	 
	 	 
	mandatory basis. Effective April 1, 2001, it is anticipated that approximately 11,000 additional

	 
	 	 
	eligible Medicaid recipients will be enrolled in the DCHFP program as a result of expanded coverage.

	 
	 	 
	This expansion program is for DC residents that are childless adults 50-64 years of age.

	 
	 	 
	ADD to Section C.1.2

	 	Applicable Documents (add)

Terms and provisions of the waiver and federal law granted to the District by the
Secretary of Health and Human Services under §1115 of the Social Security Act (U.S.C. §
1315).

See Attachment 2, Centers for Medicare and Medicaid Services (CMS), Revised Special Terms
and Conditions (6 pages) incorporated herein.EX-10.23.3

COUNTY OF TRAVIS

AMENDMENT 13

TO THE AGREEMENT BETWEEN THE

HEALTH & HUMAN SERVICES COMMISSION

AND

AMERIGROUP TEXAS, INC.

FOR HEALTH SERVICES

TO THE

CHILDREN’S HEALTH INSURANCE PROGRAM

THIS CONTRACT AMENDMENT (the “Amendment”) is entered into between the HEALTH &
HUMAN SERVICES COMMISSION (“HHSC”), an administrative agency within the executive
department of the State of Texas, and Amerigroup Texas, Inc. (“CONTRACTOR”), a health
maintenance organization organized under the laws of the State of Texas, possessing a certificate
of authority issued by the Texas Department of Insurance to operate as a health maintenance
organization, and having its principal office at 1200 Copeland Road, Suite 200, Arlington, Texas
76011. HHSC and CONTRACTOR may be referred to in this Amendment individually as a “Party”
and collectively as the “Parties.”

The Parties hereby agree to amend their original contract, HHSC contract
number 529-00-139 (the “Agreement”), as set forth in Article 2 of this
Amendment.

ARTICLE 1. PURPOSE.

Section 1.01 Authorization.

This Amendment is executed by the Parties in accordance with
Article 8 of the Agreement. Section 1.02  Modification;
Confirmation.

By this Amendment, the Parties:

(a) Amend Section 17.03 of the Agreement, concerning encounter data
specifications reports; and

(b) Confirm their prior extension of the term of the Agreement through
August 31, 2005. Section 1.03 Effective Date of changes

(a) General effective date of changes.

This Amendment is effective August 31, 2004, and terminates on the
Expiration Date of the Agreement, unless extended or terminated sooner by HHSC in
accordance with the Agreement.

ARTICLE 2. AMENDMENT TO THE OBLIGATIONS OF THE PARTIES.

Section 2.01 Modification to Section17.03 Encounter Data Specifications Reports.

Section 17.03 of the Agreement, Encounter Data Specifications Report, is amended to read as
follows: “Section 17.03 Encounter Data Specifications Reports.

1

CONTRACTOR will report encounter data each month in accordance with the
requirements of Amendment 13 Appendix G, attached hereto and incorporated herein by
reference. CONTRACTOR will submit such reports by the 10th day of each month
for encounter data from the preceding month.”

Section 2.02  Confirmation of Term of Agreement and Expiration Date.

(a) In Amendment 12, the Parties extended the term of the Agreement through
August 31, 2005 (unless extended or terminated sooner by HHSC in accordance with the
Agreement) and set forth the time and manner of premium payments for
members covered by CONTRACTOR from September 1, 2004, through August 31, 2005.

(b) The Parties hereby clarify and confirm that:

(1) the term of the Agreement is through August 31, 2005, unless extended or terminated
sooner by HHSC in accordance with the Agreement; and

(2) the term “Expiration Date” is revised to August 31, 2005, unless extended or terminated
sooner by HHSC in accordance with the Agreement.

ARTICLE 3. REPRESENTATIONS AND AGREEMENT OF THE PARTIES

The Parties contract and agree that the terms of the Agreement
will remain in effect and continue to govern except to the extent modified in
this Amendment.

By signing this Amendment, the Parties expressly understand and agree that this
Amendment is hereby made a part of the Agreement as though it were set out word for word
in the Agreement.

IN WITNESS HEREOF, HHSC and the CONTRACTOR have each caused this Amendment to be signed and
delivered by its duly authorized representative.

	 	 	 
	HEALTH AND HUMAN SERVICES COMMISSION	 	AMERIGROUP TEXAS, INC.
	By:

	 	By:
	
 
	 	 
	Albert Hawkins

Executive Commissioner

	 	Eric M. Yoder, M.D.

President and CEO
	 
	 	 
	Date:

	 	Date:
	 

	 	 
	 
	 	 

2EX-10.25.3

JEB BUSH, GOVERNOR ALAN LEVINE, SECRETARY

March 15, 2005

Mr. Mitch Wright

Amerigroup Florida, Inc.
4425 Corporation Lane
Virginia Beach, FL 23462

Dear Mr. Wright:

Enclosed is an executed copy of Amendment No. 4 to AHCA Contract No. FA523, Health Care Services
to Medicaid Beneficiaries (HMO), for your records. Should you have any questions I may be
contacted at (850) 414 — 7653.

Sincerely,

/s/ Barbara B. Vaughan

	 	 	 	Barbara B. Vaughan, Mgmt. Review Specialist Procurement Office

BBV/bv

Enclosures

cc: Christina Lopez, AHCA Contract Manager, MS #50

	 	 	 
	2727 Mahan Drive • Mail Stop #15

Tallahassee, FL 32308

	 	Visit AHCA online at

ahca.myflorida.com

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AHCA CONTRACT NO. FA523

AMENDMENT NO. 4

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

WHEREAS, the Vendor’s name has been referenced as Amerigroup of Florida, Inc. throughout the
Contract and its attachments.

WHEREAS, Amerigroup of Florida, Inc. is not the correct name of the Vendor, the correct name
being “Amerigroup Florida, Inc.”

NOW, THEREFORE, the Contract and its attachments are hereby amended to reflect the correct
Vendor name.

1. The Vendor name is hereby amended from Amerigroup of Florida, Inc. to Amerigroup Florida, Inc.

2. Standard Contract, Section ILA, 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 $663,357,697.00 (an increase of $4,531,502.00), subject to the availability of funds.

	 	3.	 	Effective March 1, 2005, Attachment I, section 90.0, Payment and Authorized Enrollment
Levels, Table 2, Area 07 is hereby amended to read as follows:

Table 2

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	Area 07 General Rates plus Mental Health Plan -
	 	015005308(ORANGE) 015005313(SEMINOLE)
	 	015005314(OSCEOLA)
	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	14-20 Male	 	14-20 Female	 	21-54 Male	 	21-54 Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	337.20	 	 	 	76.92	 	 	 	58.07	 	 	 	59.10	 	 	 	114.69	 	 	 	136.45	 	 	 	206.32	 	 	 	287.87	 	 	 	287.87	 
	SSI/No Medicare
	 	 	3217.90	 	 	 	406.84	 	 	 	260.45	 	 	 	239.73	 	 	 	239.73	 	 	 	628.24	 	 	 	628.24	 	 	 	594.96	 	 	 	594.96	 
	SSI/Part B
	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 
	SSI/Part A & B
	 	 	293.59	 	 	 	293.59	 	 	 	293.59	 	 	 	293.59	 	 	 	293.59	 	 	 	293.59	 	 	 	293.59	 	 	 	293.59	 	 	 	208.25	 

	 	4.	 	Attachment I, Section 90.0, Payment and Authorized Enrollment Levels, Table 3, the second
paragraph is hereby amended to now read:

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
$663,357,697.00 (an increase of $4,531,502.00), expressed on page seven of this contract.

	 	5.	 	This amendment shall begin on March 1, 2005, or the date on which the amendment has been
signed by both parties, whichever is later.

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

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

	 	 	 	This amendment and all its attachments are hereby made a part
of the Contract. AHCA Contract No. FA523, Amendment No. 4, Page 1
of 2	 

AHCA Form 2100-0002 (Rev. NOV03)

2

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 2 page amendment (including all
attachments) to be executed by their officials thereunto duly authorized.

	 	 	 
	AMERIGROUP FLORIDA, INC.	 	STATE OF FLORIDA, AGENCY FOR HEALTH CARE
	 	 	ADMINISTRATION
	SIGNED

BY: /s/ Don Gilmore

	 	SIGNED

BY:
	 

	 	

	 
	 	 
	NAME: Don Gilmore

TITLE: CEO

	 	NAME: Alan Levine

TITLE: Secretary
	 

	 	 
	DATE: 2/28/05

	 	DATE:
	 

	 	 

	 	 	 	REMAINDER OF PAGE INTENTIONALLY LEFT BLANK

AHCA Contract No. FA523, Amendment No. 4, Page 2 of 2

AHCA Form 2100-0002 (Rev. NOV03)

3

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 2 page amendment (including all
attachments) to be executed by their officials thereunto duly authorized.

	 	 	 	 	 
	AMERIGROUP FLORIDA, INC.	 	STATE OF FLORIDA, AGENCY FOR HEALTH
	 	 	CARE ADMINISTRATION	 	 
	SIGNED

BY:

	 	SIGNED

BY: /s/Alan Levine
	 	

	
 
	 	 
	 	 
	NAME: Don Gilmore

	 	NAME: Alan Levine
	 	

	 

	 	

	 	

	TITLE:CEO

	 	TITLE: Secretary
	 	

	 

	 	 
	 	 
	DATE:

	 	DATE: 2/28/05
	 	

	
 
	 	 
	 	 

	 	 	 	REMAINDER OF PAGE INTENTIONALLY LEFT BLANK

AHCA Contract No. FA523, Amendment No. 4, Page 2 of 2

AHCA Form 2100-0002 (Rev. NOV03)

4

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