Document:

Ninth Amendment to Managed Care Alliance Agreement

 Exhibit 10.1 
 NINTH AMENDMENT TO 
 MANAGED CARE ALLIANCE AGREEMENT 
 THIS NINTH AMENDMENT (the “Amendment”) is entered into this 4th day of February, 2008 by and between CIGNA Health Corporation, for and on behalf of its CIGNA Affiliates (individually and collectively, “CIGNA”) and Gentiva CareCentrix,
Inc. (“MCA”). 
 WITNESSETH 
 WHEREAS, CIGNA and MCA entered into a Managed Care Alliance Agreement which became effective January 1, 2004, as amended from time to time, (the “Agreement”) whereby MCA agreed to provide or arrange for the provision of
certain home health care services to Participants, as that term is defined in the Agreement; 
 WHEREAS, the parties wish to amend the Agreement to extend
the term of the Agreement and to change the capitation service rates and other designated fee for service rates effective February 1, 2008 and to include such other terms and conditions as set forth in this Amendment. 
 NOW THEREFORE, CIGNA and MCA agree to amend the Agreement as follows: 
  

	 	1.	This Ninth Amendment shall be effective on February 1, 2008 for services rendered on and after February 1, 2008. 

	 	2.	Section III.B. of the Agreement is amended to extend the term of the Agreement until January 31, 2011 and is replaced to read as follows: 

 “Term of Agreement  
 This
Agreement shall terminate on January 31, 2011. Either party may elect not to renew this Agreement by providing at least ninety (90) days advance written notice to the other party, prior to the termination date of this Agreement. If neither
party exercises such right to terminate, the existing rates will remain in place and this Agreement shall automatically renew for consecutive one (1) year terms without any further action by either party, unless either party elects not to renew
this Agreement by providing at least ninety (90) days advance written notice to the other party, prior to the commencement of the next term. 
 Notwithstanding the expiration or non-renewal of this Agreement pursuant to this Section B., this Agreement shall continue in effect with respect to those Payors covered under Service Agreements in effect as of the end of the term of this
Agreement or the notice period, as applicable, but not to exceed twelve months from the effective date of termination or expiration.” 
  

	 	3.	The notice provision of the agreement, entitled “Notice”, is hereby deleted in its entirety and replaced with the new Section III.K. as follows: 

“Any notice required hereunder shall be in writing and shall be sent by United States mail, postage prepaid, to CIGNA and MCA at the addresses set
forth below: 
  

 1 

 If to MCA: 
 Senior Vice President 
 CareCentrix 
 3 Huntington Quadrangle 200S 
 Melville, NY 11747 
 and: 
 General Counsel 
 Gentiva Health Services, Inc. 
 3 Huntington Quadrangle 200S 
 Melville, NY 11747 
 If to
CIGNA: 
 CIGNA HealthCare 
 National Contracting 
 900 Cottage Grove Road, B7NC 
 Hartford, CT 06152 
 and:

 CIGNA HealthCare 
 Legal Department 
 900 Cottage Grove Road, B6LPA 
 Hartford, CT 06152” 
  

	 	4.	Exhibit A HMO Program Attachment – Capitation Schedule of Capitation Rates is hereby deleted in its entirety and replaced with a new Exhibit A HMO Program Attachment –
Capitation Schedule of Capitation Rates attached hereto for services provided on and after February 1, 2008. 

  

	 	5.	Exhibit A HMO Program Attachment – Fee for Service Reimbursement For Other Services is hereby deleted in its entirety and replaced with a new Exhibit A HMO Program Attachment
– Fee for Service Reimbursement For Other Services attached hereto for services provided on and after February 1, 2008. 

  

	 	6.	Exhibit A Gatekeeper Program Attachment – Capitation Schedule of Capitation Rates is hereby deleted in its entirety and replaced with a new Exhibit A Gatekeeper Program
Attachment – Capitation Schedule of Capitation Rates attached hereto for services provided on and after February 1, 2008 

  

	 	7.	Exhibit A Gatekeeper Program Attachment – Fee for Service Reimbursement For Other Services is hereby deleted in its entirety and replaced with a new Exhibit A Gatekeeper
Program Attachment – Fee for Service Reimbursement For Other Services attached hereto for services provided on and after February 1, 2008. 

  

	 	8.	Exhibit A PPO & Indemnity Program Attachment – Fee for Service Reimbursement For Other Services is hereby deleted in its entirety and replaced with a new Exhibit A
PPO & Indemnity Program Attachment Reimbursement For Other Services attached hereto for services provided on and after February 1, 2008. 

  

 2 

	 	9.	CIGNA and MCA agree to the following additional terms: 

  

	 	a)	*** 

  

	 	b)	*** 

  

	 	c)	*** 

  

	 	d)	*** 

  

	 	e)	MCA will submit, by May 1, 2008, a fee schedule at code level detail to be used for CIGNA audit purposes. The Agreement will be amended at that time, if necessary, to make
changes to the Agreement to address any issues identified through such review; 

  

	 	f)	The parties will collaborate to create, by May 1, 2008, a summary report showing CAP and fee-for-service detail specific to products and geographic locations. The Agreement
will be amended at that time, if necessary, to make changes to the Agreement to address any issues identified through such review; 

  

	 	g)	*** 

  

	***	Confidential Treatment Requested. 

  

 3 

	 	10.	To the extent that the provisions in the Agreement, including any prior amendments, conflict with the terms of this Amendment (including the exhibits and schedules hereto), the
terms in this Amendment shall supersede and control. All other terms and conditions of the Agreement, including the Program Attachments and the Exhibits attached thereto, shall remain the same and in full force and effect. Capitalized terms not
defined herein but defined in the Agreement shall have the same meaning as defined in the Agreement. 

 IN WITNESS WHEREOF, CIGNA and MCA have
caused their duly authorized representatives to execute this Amendment as of the date first written above. 
  

			
	CIGNA HEALTH CORPORATION
		
	By:	 	 /s/ Joseph E. Turgeon, III,

	Its:	 	VP Network Strategy & Development
	Dated:	 	February 5, 2008
	
	GENTIVA CARECENTRIX, INC.
		
	By:	 	 /s/ Thomas Boelsen

	Its:	 	Sr. V.P
	Dated:	 	February 4, 2008

  

 4 

 EXHIBIT A 
 HMO PROGRAM ATTACHMENT - CAPITATION 
 SCHEDULE OF CAPITATION RATES 
 CAPITATION RATES EFFECTIVE 2/1/08 - 1/31/09 
 These
are the capitation rates that apply to services rendered to Patient Panel Participants enrolled in HMO Programs. An “HMO Program” means a non-governmental, fully insured HMO or Point of Service product that is underwritten based on a
community rating methodology (i.e. community rating, community rating by class, adjusted community rating by class). 
  

			
	 	  	CareCentrix
Home Health,
Infusion, DME/
HME
Capitation Rates
PMPM
	 All Commercial HMO Program Capitated Affiliates
	  	***

 Capitation Rate Compensation Terms 
 The following rates are established for the provision of Home Care Services rendered to Program Participants covered under the HMO and Gatekeeper plans: 
  

			
	February 1, 2008 - January 31, 2009	  	*** per member per month
	February 1, 2009 - January 31, 2010	  	*** per member per month
	February 1, 2010 - January 31, 2011	  	*** per member per month

 The capitation rate listed above will be allocated between HMO and Gatekeeper Program particiants in accordance
with established business practices. On or about February 1 of each year, the parties shall reconcile the allocation and settle any payment difference no later than February 28 of each calendar year. 
 If an outlier calcuation for *** demonstrates a patient per thousand (PPK) increase in excess of ***, (***), then MCA reserves the right to propose an *** pmpm outlier
adjustment. CIGNA may elect to accept this adjustment or *** and *** from this agreement. 
  

	***	Confidential Treatment Requested. 

 EXHIBIT A 
 HMO PROGRAM ATTACHMENT - FEE FOR SERVICE 
 REIMBURSEMENT FOR OTHER SERVICES 
 RATE AREA DESIGNATIONS: 
  

					
	 STATE
	 	 RATE AREA
	 	 RATE DESIGNATION

	 Alabama
	 	***	 	***
	 Alaska
	 	***	 	***
	 Arizona
	 	***	 	***
	 Arkansas
	 	***	 	***
	 California
	 	***	 	***
	 Colorado
	 	***	 	***
	 Connecticut
	 	***	 	***
	 Delaware
	 	***	 	***
	 District of Columbia
	 	***	 	***
	 Florida
	 	***	 	***
	 Georgia
	 	***	 	***
	 Hawaii
	 	***	 	***
	 Idaho
	 	***	 	***
	 Illinois
	 	***	 	***
	 Indiana
	 	***	 	***
	 Iowa
	 	***	 	***
	 Kansas
	 	***	 	***
	 Kentucky
	 	***	 	***
	 Louisiana
	 	***	 	***
	 Maine
	 	***	 	***
	 Maryland
	 	***	 	***
	 Massachusetts
	 	***	 	***
	 Michigan
	 	***	 	***
	 Minnesota
	 	***	 	***
	 Mississippi
	 	***	 	***
	 Missouri
	 	***	 	***
	 Montana
	 	***	 	***
	 Nebraska
	 	***	 	***
	 Nevada
	 	***	 	***
	 New Hampshire
	 	***	 	***
	 New Jersey
	 	***	 	***
	 New Mexico
	 	***	 	***
	 New York
	 	***	 	***
	 North Carolina
	 	***	 	***
	 North Dakota
	 	***	 	***
	 Ohio
	 	***	 	***
	 Oklahoma
	 	***	 	***
	 Oregon
	 	***	 	***
	 Pennsylvania
	 	***	 	***
	 Rhode Island
	 	***	 	***
	 South Carolina
	 	***	 	***
	 South Dakota
	 	***	 	***
	 Tennessee
	 	***	 	***
	 Texas
	 	***	 	***
	 Utah
	 	***	 	***
	 Vermont
	 	***	 	***
	 Virginia
	 	***	 	***
	 Washington
	 	***	 	***
	 West Virginia
	 	***	 	***
	 Wisconsin
	 	***	 	***
	 Wyoming
	 	***	 	***

  

	***	Confidential Treatment Requested 

 TRADITIONAL HOME HEALTH FEE-FOR-SERVICE RATES 
 HMO RATES EFFECTIVE FEBRUARY 1, 2008 - JANUARY 31, 2009 
 The following Traditional Home Health Services have both Visit and Hourly rates. 
  

													
	 Notes 1, 2, 3, 4, 5 and 6 apply
	  	Area 1	 	Area 2	 	Area 3
	  	Visit	 	Hour	 	Visit	 	Hour	 	Visit	 	Hour
	 CERTIFIED NURSES AIDE
	  	***	 	***	 	***	 	***	 	***	 	***
	 HOME HEALTH AIDE
	  	***	 	***	 	***	 	***	 	***	 	***
	 LVN/LPN
	  	***	 	***	 	***	 	***	 	***	 	***
	 LVN/LPN - HIGH TECH
	  	***	 	***	 	***	 	***	 	***	 	***
	 PEDIATRIC HIGH TECH LVN/LPN
	  	***	 	***	 	***	 	***	 	***	 	***
	 PEDIATRIC HIGH TECH RN
	  	***	 	***	 	***	 	***	 	***	 	***
	 PEDIATRIC LVN/LPN
	  	***	 	***	 	***	 	***	 	***	 	***
	 PEDIATRIC RN
	  	***	 	***	 	***	 	***	 	***	 	***
	 RN
	  	***	 	***	 	***	 	***	 	***	 	***
	 RN HIGH TECH INFUSION
	  	***	 	***	 	***	 	***	 	***	 	***
	 RN HIGH TECH OTHER
	  	***	 	***	 	***	 	***	 	***	 	***
	
	The following Traditional Home Health Services have Visit only rates.
				
	 Notes 1, 3, 4, 5, 7 and 8 apply
	  	Area 1	 	Area 2	 	Area 3
	  	Visit	 	Hour	 	Visit	 	Hour	 	Visit	 	Hour
	 DIABETIC NURSE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 DIETITIAN
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 ENTEROSTOMAL THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 MATERNAL CHILD HEALTH
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 MEDICAL SOCIAL WORKER
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 OCCUPATIONAL THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 OCCUPATIONAL THERAPIST ASSISTANT
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PHLEBOTOMIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PHOTOTHERAPY PACKAGE SERVICE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PHYSICAL THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PHYSICAL THERAPIST ASSISTANT
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PSYCHIATRIC NURSE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 REHABILITATION NURSE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 RESPIRATORY THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 RN ASSESSMENT, INITIAL
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 RN SKILLED NURSING VISIT-EXTENSIVE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 SPEECH THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 WOUND CARE—RN
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 WOUND CARE—LVN/LPN
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	
	The following Traditional Home Health Service has Hourly only rates.
				
	 Notes 3, 4 and 5 apply
	  	Area 1	 	Area 2	 	Area 3
	  	Visit	 	Hour	 	Visit	 	Hour	 	Visit	 	Hour
							
	 HOMEMAKER
	  	N/A	 	***	 	N/A	 	***	 	N/A	 	***
	
	The following Traditional Home Health Service is priced on a Per Diem basis.
				
	 Notes 3, 4 and 5 apply
	  	Area 1	 	Area 2	 	Area 3
	  	 	 	Per
Diem	 	 	 	Per
Diem	 	 	 	Per
Diem
							
	 COMPANION/LIVE IN
	  		 	***	 		 	***	 		 	***

 NOTES: 
  

	1.	Visits are defined as two (2) hours or less in duration (EXCEPT MATERNAL CHILD HEALTH VISITS, which have no maximum duration). 

  

	2.	Hourly rate for visits exceeding two (2) hours in duration, starting with hour 3. 

  

	3.	CIGNA does not reimburse for travel time, weekend, holiday or evening differentials. 

  

	4.	Above prices have no exclusions. 

  

	5.	All services not listed above will be billed at *** until rates are mutually established and become part of the fee schedule. 

  

	6.	RN High Tech Infusion visit and hourly utilization/costs to be reported with HIT. 

  

	7.	Respiratory Therapist visit utilization/costs to be reported with HME/RT. 

  

	8.	Diabetic Nurse, Psychiatric Nurse and Rehabilitation Nurse assume specialty certification which is not readily available in the home care environment. Use requires special
coordination. 

  

	***	Confidential Treatment Requested. 

 TRADITIONAL HOME HEALTH FEE-FOR-SERVICE RATES 
 HMO RATES EFFECTIVE FEBRUARY 1, 2009 - JANUARY 31, 2010 
 The following Traditional Home Health Services have both Visit and Hourly rates. 
  

													
	 Notes 1, 2, 3, 4, 5 and 6 apply
	  	Area 1	 	Area 2	 	Area 3
	  	Visit	 	Hour	 	Visit	 	Hour	 	Visit	 	Hour
	 CERTIFIED NURSES AIDE
	  	***	 	***	 	***	 	***	 	***	 	***
	 HOME HEALTH AIDE
	  	***	 	***	 	***	 	***	 	***	 	***
	 LVN/LPN
	  	***	 	***	 	***	 	***	 	***	 	***
	 LVN/LPN - HIGH TECH
	  	***	 	***	 	***	 	***	 	***	 	***
	 PEDIATRIC HIGH TECH LVN/LPN
	  	***	 	***	 	***	 	***	 	***	 	***
	 PEDIATRIC HIGH TECH RN
	  	***	 	***	 	***	 	***	 	***	 	***
	 PEDIATRIC LVN/LPN
	  	***	 	***	 	***	 	***	 	***	 	***
	 PEDIATRIC RN
	  	***	 	***	 	***	 	***	 	***	 	***
	 RN
	  	***	 	***	 	***	 	***	 	***	 	***
	 RN HIGH TECH INFUSION
	  	***	 	***	 	***	 	***	 	***	 	***
	 RN HIGH TECH OTHER
	  	***	 	***	 	***	 	***	 	***	 	***
	
	The following Traditional Home Health Services have Visit only rates.
				
	 Notes 1, 3, 4, 5, 7 and 8 apply
	  	Area 1	 	Area 2	 	Area 3
	  	Visit	 	Hour	 	Visit	 	Hour	 	Visit	 	Hour
	 DIABETIC NURSE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 DIETITIAN
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 ENTEROSTOMAL THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 MATERNAL CHILD HEALTH
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 MEDICAL SOCIAL WORKER
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 OCCUPATIONAL THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 OCCUPATIONAL THERAPIST ASSISTANT
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PHLEBOTOMIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PHOTOTHERAPY PACKAGE SERVICE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PHYSICAL THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PHYSICAL THERAPIST ASSISTANT
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PSYCHIATRIC NURSE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 REHABILITATION NURSE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 RESPIRATORY THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 RN ASSESSMENT, INITIAL
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 RN SKILLED NURSING VISIT-EXTENSIVE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 SPEECH THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 WOUND CARE—RN
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 WOUND CARE—LVN/LPN
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	
	The following Traditional Home Health Service has Hourly only rates.
				
	 Notes 3, 4 and 5 apply
	  	Area 1	 	Area 2	 	Area 3
	  	Visit	 	Hour	 	Visit	 	Hour	 	Visit	 	Hour
							
	 HOMEMAKER
	  	N/A	 	***	 	N/A	 	***	 	N/A	 	***
	
	The following Traditional Home Health Service is priced on a Per Diem basis.
				
	 Notes 3, 4 and 5 apply
	  	Area 1	 	Area 2	 	Area 3
	  	 	 	Per
Diem	 	 	 	Per
Diem	 	 	 	Per
Diem
	 COMPANION/LIVE IN
	  		 	***	 		 	***	 		 	***

 NOTES: 
  

	1.	Visits are defined as two (2) hours or less in duration (EXCEPT MATERNAL CHILD HEALTH VISITS, which have no maximum duration). 

  

	2.	Hourly rate for visits exceeding two (2) hours in duration, starting with hour 3. 

  

	3.	CIGNA does not reimburse for travel time, weekend, holiday or evening differentials. 

  

	4.	Above prices have no exclusions. 

  

	5.	All services not listed above will be billed at *** until rates are mutually established and become part of the fee schedule. 

  

	6.	RN High Tech Infusion visit and hourly utilization/costs to be reported with HIT. 

  

	7.	Respiratory Therapist visit utilization/costs to be reported with HME/RT. 

  

	8.	Diabetic Nurse, Psychiatric Nurse and Rehabilitation Nurse assume specialty certification which is not readily available in the home care environment. Use requires special
coordination. 

  

	***	Confidential Treatment Requested. 

 TRADITIONAL HOME HEALTH FEE-FOR-SERVICE RATES 
 HMO RATES EFFECTIVE FEBRUARY 1, 2010 - JANUARY 31. 2011 
 The following Traditional Home Health Services have both Visit and Hourly rates. 
  

																
	 Notes 1, 2, 3, 4, 5 and 6 apply
	  	Area 1	 	 	Area 2	 	 	Area 3	 
	  	Visit	 	Hour	 	 	Visit	 	Hour	 	 	Visit	 	Hour	 
	 CERTIFIED NURSES AIDE
	  	***	 	***	 	 	***	 	***	 	 	***	 	***	 
	 HOME HEALTH AIDE
	  	***	 	***	 	 	***	 	***	 	 	***	 	***	 
	 LVN/LPN
	  	***	 	***	 	 	***	 	***	 	 	***	 	***	 
	 LVN/LPN - HIGH TECH
	  	***	 	***	 	 	***	 	***	 	 	***	 	***	 
	 PEDIATRIC HIGH TECH LVN/LPN
	  	***	 	***	 	 	***	 	***	 	 	***	 	***	 
	 PEDIATRIC HIGH TECH RN
	  	***	 	***	 	 	***	 	***	 	 	***	 	***	 
	 PEDIATRIC LVN/LPN
	  	***	 	***	 	 	***	 	***	 	 	***	 	***	 
	 PEDIATRIC RN
	  	***	 	***	 	 	***	 	***	 	 	***	 	***	 
	 RN
	  	***	 	***	 	 	***	 	***	 	 	***	 	***	 
	 RN HIGH TECH INFUSION
	  	***	 	***	 	 	***	 	***	 	 	***	 	***	 
	 RN HIGH TECH OTHER
	  	***	 	***	 	 	***	 	***	 	 	***	 	***	 
	
	The following Traditional Home Health Services have Visit only rates.	 
				
	 Notes 1, 3, 4, 5, 7 and 8 apply
	  	Area 1	 	 	Area 2	 	 	Area 3	 
	  	Visit	 	Hour	 	 	Visit	 	Hour	 	 	Visit	 	Hour	 
	 DIABETIC NURSE
	  	***	 	N/A	 	 	***	 	N/A	 	 	***	 	N/A	 
	 DIETITIAN
	  	***	 	N/A	 	 	***	 	N/A	 	 	***	 	N/A	 
	 ENTEROSTOMAL THERAPIST
	  	***	 	N/A	 	 	***	 	N/A	 	 	***	 	N/A	 
	 MATERNAL CHILD HEALTH
	  	***	 	N/A	 	 	***	 	N/A	 	 	***	 	N/A	 
	 MEDICAL SOCIAL WORKER
	  	***	 	N/A	 	 	***	 	N/A	 	 	***	 	N/A	 
	 OCCUPATIONAL THERAPIST
	  	***	 	N/A	 	 	***	 	N/A	 	 	***	 	N/A	 
	 OCCUPATIONAL THERAPIST ASSISTANT
	  	***	 	N/A	 	 	***	 	N/A	 	 	***	 	N/A	 
	 PHLEBOTOMIST
	  	***	 	N/A	 	 	***	 	N/A	 	 	***	 	N/A	 
	 PHOTOTHERAPY PACKAGE SERVICE
	  	***	 	N/A	 	 	***	 	N/A	 	 	***	 	N/A	 
	 PHYSICAL THERAPIST
	  	***	 	N/A	 	 	***	 	N/A	 	 	***	 	N/A	 
	 PHYSICAL THERAPIST ASSISTANT
	  	***	 	N/A	 	 	***	 	N/A	 	 	***	 	N/A	 
	 PSYCHIATRIC NURSE
	  	***	 	N/A	 	 	***	 	N/A	 	 	***	 	N/A	 
	 REHABILITATION NURSE
	  	***	 	N/A	 	 	***	 	N/A	 	 	***	 	N/A	 
	 RESPIRATORY THERAPIST
	  	***	 	N/A	 	 	***	 	N/A	 	 	***	 	N/A	 
	 RN ASSESSMENT, INITIAL
	  	***	 	N/A	 	 	***	 	N/A	 	 	***	 	N/A	 
	 RN SKILLED NURSING VISIT-EXTENSIVE
	  	***	 	N/A	 	 	***	 	N/A	 	 	***	 	N/A	 
	 SPEECH THERAPIST
	  	***	 	N/A	 	 	***	 	N/A	 	 	***	 	N/A	 
	 WOUND CARE—RN
	  	***	 	N/A	 	 	***	 	N/A	 	 	***	 	N/A	 
	 WOUND CARE—LVN/LPN
	  	***	 	N/A	 	 	***	 	N/A	 	 	***	 	N/A	 
	
	The following Traditional Home Health Service has Hourly only rates.	 
				
	 Notes 3, 4 and 5 apply
	  	Area 1	 	 	Area 2	 	 	Area 3	 
	  	Visit	 	Hour	 	 	Visit	 	Hour	 	 	Visit	 	Hour	 
							
	 HOMEMAKER
	  	N/A	 	***	 	 	N/A	 	***	 	 	N/A	 	***	 
	
	The following Traditional Home Health Service is priced on a Per Diem basis.	 
				
	 Notes 3, 4 and 5 apply
	  	Area 1	 	 	Area 2	 	 	Area 3	 
	  	 	 	Per
Diem	 	 	 	 	Per
Diem	 	 	 	 	Per
Diem	 
							
	 COMPANION/LIVE IN
	  		 	*	**	 		 	*	**	 		 	*	**

 NOTES: 
  

	1.	Visits are defined as two (2) hours or less in duration (EXCEPT MATERNAL CHILD HEALTH VISITS, which have no maximum duration). 

  

	2.	Hourly rate for visits exceeding two (2) hours in duration, starting with hour 3. 

  

	3.	CIGNA does not reimburse for travel time, weekend, holiday or evening differentials. 

  

	4.	Above prices have no exclusions. 

  

	5.	All services not listed above will be billed at *** until rates are mutually established and become part of the fee schedule. 

  

	6.	RN High Tech Infusion visit and hourly utilization/costs to be reported with HIT. 

  

	7.	Respiratory Therapist visit utilization/costs to be reported with HME/RT. 

  

	8.	Diabetic Nurse, Psychiatric Nurse and Rehabilitation Nurse assume specialty certification which is not readily available in the home care environment. Use requires special
coordination. 

  

	***	Confidential Treatment Requested. 

 HOME INFUSION RATES 
 HMO RATES EFFECTIVE FEBRUARY 1, 2008 - JANUARY 31, 2009 
 The following Home Infusion Therapy service rates
EXCLUDE drugs. Drugs are priced as a percentage discount off AWP (if applicable), and there is NO price difference between primary and multiple therapies 
  

								
	 	  	Primary or
Multiple Therapy
Per Diem	 	Primary or
Multiple Therapy
Dispensing Fee	 	Primary or
Multiple Therapy
Drug Discount off AWP	 
	 Ancillary Drugs
	  		 	***	 	***	 
	 Biological Response Modifiers
	  		 	***	 	***	 
	 Cardiac (Inotropic) Therapy
	  	***	 		 	***	 
	 Chelation Therapy
	  	***	 		 	***	 
	 Chemotherapy
	  	***	 		 	***	 
	 Enzyme Therapy
	  	***	 		 	***	 
	 Growth Hormone
	  		 	***	 	***	 
	 IV Immune Globulin
	  	***	 		 	***	 
	 Other Injectable Therapies
	  		 	***	 	***	 
	 Other Infusion Therapies
	  	***	 		 	***	 
	 Pain Management Therapy
	  	***	 		 	***	 
	 Steroid Therapy
	  	***	 		 	***	 
	 Thrombolytic (Anticoagulation) Therapy
	  	***	 		 	***	 
	 Synagis
	  		 	***	 	***	 
	 Remodulin Therapy
	  	***	 		 	***	 
	
	The following Home Infusion Therapy service rates EXCLUDE drugs. Drugs are priced as a percentage discount off AWP, and there IS a price difference between primary and multiple
anti-infective therapies	  
				
	 	  	Per Diem	 	 	 	Drug Discount Off AWP	 
	 Anti-Infectives - Primary Anti-Infective
	  	***	 		 	***	 
	 Anti-Infectives - Multiple Anti-Infective
	  	***	 		 	***	 
	
	The following Home Infusion Therapy service rate EXCLUDES drugs. Drugs are priced per vial, and there is NO price difference between primary and multiple anti-infective
therapies	  
				
	 	  	Primary or
Multiple Therapy
Per Diem	 	 	 	Cost of Drug	 
	 Flolan Therapy
	  	***	 		 		
	 Flolan 0.5 mg vial
	  		 		 	*	**
	 Flolan 1.5 mg vial
	  		 		 	*	**
	 Flolan diluent vial
	  		 		 	*	**
	
	The following Home Infusion Therapy service rates INCLUDE drugs, and there is NO price difference between primary and multiple therapies	  
				
	 	  	Primary or
Multiple Therapy
Per Diem	 	 	 	 	 
	 Hydration Therapy
	  	***	 		 		
	 Total Parenteral Nutrition
	  	***	 		 		

  
 *** Confidential Treatment Requested. 

 SCHEDULE 2A, PAGE 2: HOME INFUSION THERAPY HMO FEE-FOR-SERVICE RATES 
 NOTES: 
  

	1.	Per Diems EXCLUDING drugs include all costs related to the therapy except the cost of drugs, including but not limited to facility overhead, supplies, delivery, professional labor
including compounding and monitoring, all nursing required, maintenance of specialized catheters, equipment/patient supplies, disposables, pumps, general and administrative expenses, etc. 

  

	2.	Per Diems INCLUDING drugs include ALL costs - including but not limited to cost of drugs, facility overhead, supplies, delivery, professional labor including compounding and
monitoring, all nursing required, maintenance of specialized catheters, equipment/patient supplies, disposables, pumps, general and administrative expenses, etc. 

  

	3.	“DISPENSING FEE” is defined as per each time the drug is dispensed by the home infusion provider. 

  

	4.	“PER DIEM” costs are the same for primary or multiple treatments for all drug categories, except ANTI-INFECTIVES. 

  

	5.	The per diem rate shall only be charged for those days the Participant receives medication. 

  

	6.	For home infusion pharmaceuticals not listed on fee schedule, *** will apply. 

  

	7.	All Medications are subject to MAC pricing, where applicable 

 The
following are for the stated item ONLY. Unless otherwise noted, nursing, supplies, etc. are NOT included. 
  

							
	 Blood Transfusion per Unit (Tubing, Filters)
	  		  		  	***
	 Catheter Care Per Diem
	  		  		  	***
	 Midline Insertion (Catheter & Supplies)
	  		  		  	***
	 PICC Line Insertion (Catheter & Supplies)
	  		  		  	***
	 Blood Product
	  		  		  	***

  

	***	Confidential Treatment Requested. 

 SCHEDULE 2A, PAGE 3: HOME INFUSION THERAPY HMO FEE-FOR-SERVICE RATES 
  

							
	 Factor Concentrates
  
	  		  		 	
	 	  	 	  	Vial price	 	Unit Price
	Factor VII	  		  		 	
	 Novoseven 1200MCG Vial
	  		  	***	 	
	 Novoseven 4800MCG Vial
	  		  	***	 	
	 Novoseven in 1200MCG or 4800MCG QTY
	  		  		 	***
				
	Factor VIII (Recombinant)	  		  		 	
	 Recombinate
	  		  		 	***
	 Kogenate or Helixate
	  		  		 	***
	 Bioclate
	  		  		 	***
	 Helixate FS
	  		  		 	***
	 Kogenate FS
	  		  		 	***
	 Refacto
	  		  		 	***
	 Advate
	  		  		 	***
				
	Factor VIII (Monoclonal)	  		  		 	
	 Hemofil-M or A. R. C. Method M
	  		  		 	***
	 Monoclate P
	  		  		 	***
	 Monarc-M
	  		  		 	***
				
	Factor VIII (Other)	  		  		 	
	 Koate
	  		  		 	***
	 Humate
	  		  		 	***
	 Alphanate SDHT
	  		  		 	***
	 Factor IX (Recombinant)
	  		  		 	
	 BeneFix
	  		  		 	***
				
	Factor IX (Monoclonal/High Purity)	  		  		 	
	 Mononine
	  		  		 	***
	 Alphanine
	  		  		 	***
				
	Factor IX (Other)	  		  		 	
	 Konyne—80
	  		  		 	***
	 Proplex T
	  		  		 	***
	 Bebulin
	  		  		 	***
	 Profilnine SD
	  		  		 	***
				
	Anti-Inhibitor Complex	  		  		 	
	 Autoplex-T
	  		  		 	***
	 Feiba-VH
	  		  		 	***
	 Hyate-C
	  		  		 	***
				
	HEMOSTATIC AGENTS	  		  		 	
	 DDAVP—10ml vial
	  		  		 	***
	 Stimate —2.5ml vial
	  		  		 	***

 Above rates include all necessary ancillary supplies and waste disposal unit; 24-hour on-call clinical support;
home infusion monitoring system; product delivery nationwide; patient training, education, and evaluation 
  

	***	Confidential Treatment Requested. 

 HOME INFUSION RATES 
 HMO RATES EFFECTIVE FEBRUARY 1, 2009—JANUARY 31, 2010 
 The following Home Infusion Therapy service rates
EXCLUDE drugs. Drugs are priced as a percentage discount off AWP (if applicable), and there is NO price difference between primary and multiple therapies 
  

								
	 	  	Primary or
Multiple Therapy
Per Diem	 	Primary or
Multiple Therapy
Dispensing Fee	 	Primary or
Multiple Therapy
Drug Discount off AWP	 
	 Ancillary Drugs
	  		 	***	 	***	 
	 Biological Response Modifiers
	  		 	***	 	***	 
	 Cardiac (Inotropic) Therapy
	  	***	 		 	***	 
	 Chelation Therapy
	  	***	 		 	***	 
	 Chemotherapy
	  	***	 		 	***	 
	 Enzyme Therapy
	  	***	 		 	***	 
	 Growth Hormone
	  		 	***	 	***	 
	 IV Immune Globulin
	  	***	 		 	***	 
	 Other Injectable Therapies
	  		 	***	 	***	 
	 Other Infusion Therapies
	  	***	 		 	***	 
	 Pain Management Therapy
	  	***	 		 	***	 
	 Steroid Therapy
	  	***	 		 	***	 
	 Thrombolytic (Anticoagulation) Therapy
	  	***	 		 	***	 
	 Synagis
	  		 	***	 	***	 
	 Remodulin Therapy
	  	***	 		 	***	 
	
	The following Home Infusion Therapy service rates EXCLUDE drugs. Drugs are priced as a percentage discount off AWP, and there IS a price difference between primary and multiple
anti-infective therapies	  
				
	 	  	Per Diem	 	 	 	Drug Discount Off
AWP	 
	 Anti-Infectives—Primary Anti-Infective
	  	***	 		 	***	 
	 Anti-Infectives—Multiple Anti-Infective
	  	***	 		 	***	 
	
	The following Home Infusion Therapy service rate EXCLUDES drugs. Drugs are priced per vial, and there is NO price difference between primary and multiple anti-infective
therapies	  
				
	 	  	Primary or
Multiple Therapy
Per Diem	 	 	 	Cost of Drug	 
	 Flolan Therapy
	  	***	 		 		
	 Flolan 0.5 mg vial
	  		 		 	*	**
	 Flolan 1.5 mg vial
	  		 		 	*	**
	 Flolan diluent vial
	  		 		 	*	**
	
	The following Home Infusion Therapy service rates INCLUDE drugs, and there is NO price difference between primary and multiple therapies	  
				
	 	  	Primary or
Multiple Therapy
Per Diem	 	 	 	 	 
	 Hydration Therapy
	  	***	 		 		
	 Total Parenteral Nutrition
	  	***	 		 		

  

	***	Confidential Treatment Requested. 

 SCHEDULE 2A, PAGE 2: HOME INFUSION THERAPY HMO FEE-FOR-SERVICE RATES 
 NOTES: 
  

	1.	Per Diems EXCLUDING drugs include all costs related to the therapy except the cost of drugs, including but not limited to facility overhead, supplies, delivery, professional labor
including compounding and monitoring, all nursing required, maintenance of specialized catheters, equipment/patient supplies, disposables, pumps, general and administrative expenses, etc. 

  

	2.	Per Diems INCLUDING drugs include ALL costs—including but not limited to cost of drugs, facility overhead, supplies, delivery, professional labor including compounding and
monitoring, all nursing required, maintenance of specialized catheters, equipment/patient supplies, disposables, pumps, general and administrative expenses, etc. 

  

	3.	“DISPENSING FEE” is defined as per each time the drug is dispensed by the home infusion provider. 

  

	4.	“PER DIEM” costs are the same for primary or multiple treatments for all drug categories, except ANTI-INFECTIVES. 

  

	5.	The per diem rate shall only be charged for those days the Participant receives medication. 

  

	6.	For home infusion pharmaceuticals not listed on fee schedule, *** will apply. 

  

	7.	All Medications are subject to MAC pricing, where applicable 

 The
following are for the stated item ONLY. Unless otherwise noted, nursing, supplies, etc. are NOT included. 
  

							
	 Blood Transfusion per Unit (Tubing, Filters)
	  		  		  	***
	 Catheter Care Per Diem
	  		  		  	***
	 Midline Insertion (Catheter & Supplies)
	  		  		  	***
	 PICC Line Insertion (Catheter & Supplies)
	  		  		  	***
	 Blood Product
	  		  		  	***

  

	***	Confidential Treatment Requested. 

 SCHEDULE 2A, PAGE 3: HOME INFUSION THERAPY HMO FEE-FOR-SERVICE RATES 
 Factor Concentrates 
  

							
	 	  	 	  	Vial price	 	Unit Price
	Factor VII	  		  		 	
	 Novoseven 1200MCG Vial
	  		  	***	 	
	 Novoseven 4800MCG Vial
	  		  	***	 	
	 Novoseven in 1200MCG or 4800MCG QTY
	  		  		 	***
	 Factor VIII (Recombinant)
	  		  		 	
	 Recombinate
	  		  		 	***
	 Kogenate or Helixate
	  		  		 	***
	 Bioclate
	  		  		 	***
	 Helixate FS
	  		  		 	***
	 Kogenate FS
	  		  		 	***
	 Refacto
	  		  		 	***
	 Advate
	  		  		 	***
				
	Factor VIII (Monoclonal)	  		  		 	
	 Hemofil-M or A. R. C. Method M
	  		  		 	***
	 Monoclate P
	  		  		 	***
	 Monarc-M
	  		  		 	***
				
	Factor VIII (Other)	  		  		 	
	 Koate
	  		  		 	***
	 Humate
	  		  		 	***
	 Alphanate SDHT
	  		  		 	***
				
	Factor IX (Recombinant)	  		  		 	
	 BeneFix
	  		  		 	***
				
	Factor IX (Monoclonal/High Purity)	  		  		 	
	 Mononine
	  		  		 	***
	 Alphanine
	  		  		 	***
	Factor IX (Other)	  		  		 	
				
	 Konyne—80
	  		  		 	***
	 Proplex T
	  		  		 	***
	 Bebulin
	  		  		 	***
	 Profilnine SD
	  		  		 	***
				
	Anti-Inhibitor Complex	  		  		 	
	 Autoplex-T
	  		  		 	***
	 Feiba-VH
	  		  		 	***
	 Hyate-C
	  		  		 	***
				
	HEMOSTATIC AGENTS	  		  		 	
	 DDAVP—10ml vial
	  		  		 	***
	 Stimate —2.5ml vial
	  		  		 	***

 Above rates include all necessary ancillary supplies and waste disposal unit; 24-hour on-call clinical support;
home infusion monitoring system; product delivery nationwide; patient training, education, and evaluation 
  

	***	Confidential Treatment Requested. 

 HOME INFUSION RATES 
 HMO RATES EFFECTIVE FEBRUARY 1, 2010—JANUARY 31, 2011 
 The following Home Infusion Therapy service rates
EXCLUDE drugs. Drugs are priced as a percentage discount off AWP (if applicable), and there is NO price difference between primary and multiple therapies 
  

							
	 	  	Primary or
Multiple Therapy
Per Diem	 	Primary or
Multiple Therapy
Dispensing Fee	 	Primary or
Multiple Therapy
Drug Discount off AWP
	 Ancillary Drugs
	  		 	***	 	***
	 Biological Response Modifiers
	  		 	***	 	***
	 Cardiac (Inotropic) Therapy
	  	***	 		 	***
	 Chelation Therapy
	  	***	 		 	***
	 Chemotherapy
	  	***	 		 	***
	 Enzyme Therapy
	  	***	 		 	***
	 Growth Hormone
	  		 	***	 	***
	 IV Immune Globulin
	  	***	 		 	***
	 Other Injectable Therapies
	  		 	***	 	***
	 Other Infusion Therapies
	  	***	 		 	***
	 Pain Management Therapy
	  	***	 		 	***
	 Steroid Therapy
	  	***	 		 	***
	 Thrombolytic (Anticoagulation) Therapy
	  	***	 		 	***
	 Synagis
	  		 	***	 	***
	 Remodulin Therapy
	  	***	 		 	***
	
	The following Home Infusion Therapy service rates EXCLUDE drugs. Drugs are priced as a percentage discount off AWP, and there IS a price difference between primary and multiple
anti-infective therapies
				
	 	  	Per Diem	 	 	 	Drug Discount Off AWP
	 Anti-Infectives—Primary Anti-Infective
	  	***	 		 	***
	 Anti-Infectives—Multiple Anti-Infective
	  	***	 		 	***
	
	The following Home Infusion Therapy service rate EXCLUDES drugs. Drugs are priced per vial, and there is NO price difference between primary and multiple anti-infective
therapies
				
	 	  	Primary or
Multiple Therapy
Per Diem	 	 	 	Cost of Drug
	 Flolan Therapy
	  	***	 		 	
	 Flolan 0.5 mg vial
	  		 		 	***
	 Flolan 1.5 mg vial
	  		 		 	***
	 Flolan diluent vial
	  		 		 	***
	
	The following Home Infusion Therapy service rates INCLUDE drugs, and there is NO price difference between primary and multiple therapies
				
	 	  	Primary or
Multiple Therapy
Per Diem	 	 	 	 
	 Hydration Therapy
	  	***	 		 	
	 Total Parenteral Nutrition
	  	***	 		 	

  

	***	Confidential Treatment Requested. 

 SCHEDULE 2A, PAGE 2: HOME INFUSION THERAPY HMO FEE-FOR-SERVICE RATES 
 NOTES: 
  

	1.	Per Diems EXCLUDING drugs include all costs related to the therapy except the cost of drugs, including but not limited to facility overhead, supplies, delivery, professional labor
including compounding and monitoring, all nursing required, maintenance of specialized catheters, equipment/patient supplies, disposables, pumps, general and administrative expenses, etc. 

  

	2.	Per Diems INCLUDING drugs include ALL costs - including but not limited to cost of drugs, facility overhead, supplies, delivery, professional labor including compounding and
monitoring, all nursing required, maintenance of specialized catheters, equipment/patient supplies, disposables, pumps, general and administrative expenses, etc. 

  

	3.	“DISPENSING FEE” is defined as per each time the drug is dispensed by the home infusion provider. 

  

	4.	“PER DIEM” costs are the same for primary or multiple treatments for all drug categories, except ANTI-INFECTIVES. 

  

	5.	The per diem rate shall only be charged for those days the Participant receives medication. 

  

	6.	For home infusion pharmaceuticals not listed on fee schedule, *** will apply. 

  

	7.	All Medications are subject to MAC pricing, where applicable 

 The
following are for the stated item ONLY. Unless otherwise noted, nursing, supplies, etc. are NOT included. 
  

								
	 Blood Transfusion per Unit (Tubing, Filters)
	 		 		  	*	**
	 Catheter Care Per Diem
	 		 		  	*	**
	 Midline Insertion (Catheter & Supplies)
	 		 		  	*	**
	 PICC Line Insertion (Catheter & Supplies)
	 		 		  	*	**
	 Blood Product
	 		 		  	*	**

  

	***	Confidential Treatment Requested. 

 SCHEDULE 2A, PAGE 3: HOME INFUSION THERAPY HMO FEE-FOR-SERVICE RATES 
  

					
	 Factor Concentrates
	  		  	
			
	 	  	 Vial price
	  	 Unit Price

			
	 Factor VII
	  		  	
	 Novoseven 1200MCG Vial
	  	***	  	
	 Novoseven 4800MCG Vial
	  	***	  	
	 Novoseven in 1200MCG or 4800MCG QTY
	  		  	***
			
	 Factor VIII (Recombinant)
	  		  	
	 Recombinate
	  		  	***
	 Kogenate or Helixate
	  		  	***
	 Bioclate
	  		  	***
	 Helixate FS
	  		  	***
	 Kogenate FS
	  		  	***
	 Refacto
	  		  	***
	 Advate
	  		  	***
			
	 Factor VIII (Monoclonal)
	  		  	
	 Hemofil-M or A. R. C. Method M
	  		  	***
	 Monoclate P
	  		  	***
	 Monarc-M
	  		  	***
			
	 Factor VIII (Other)
	  		  	
	 Koate
	  		  	***
	 Humate
	  		  	***
	 Alphanate SDHT
	  		  	***
			
	 Factor IX (Recombinant)
	  		  	
	 BeneFix
	  		  	***
			
	 Factor IX (Monoclonal/High Purity)
	  		  	
	 Mononine
	  		  	***
	 Alphanine
	  		  	***
			
	 Factor IX (Other)
	  		  	
	 Konyne - 80
	  		  	***
	 Proplex T
	  		  	***
	 Bebulin
	  		  	***
	 Profilnine SD
	  		  	***
			
	 Anti-Inhibitor Complex
	  		  	
	 Autoplex-T
	  		  	***
	 Feiba-VH
	  		  	***
	 Hyate-C
	  		  	***
			
	 HEMOSTATIC AGENTS
	  		  	
	 DDAVP - 10ml vial
	  		  	***
	 Stimate - 2.5ml vial
	  		  	***

 Above rates include all necessary ancillary supplies and waste disposal unit; 24-hour on-call clinical support;
home infusion monitoring system; product delivery nationwide; patient training, education, and evaluation 
  

	***	Confidential Treatment Requested. 

 DME / HME RESPIRATORY RATES: 
 HMO RATES EFFECTIVE FEBRUARY 1, 2008—JANUARY 31. 2011 
  

																	
	 CAT
	  	 TYPE
	  	HCPCS
CODE	  	CHC
CODE	  	CareCentrix
Code	  	 DESCRIPTION
	  	 PURCHASE
PRICE
	  	 RENTAL
PRICE
	  	 DAILY
PRICE

	 HME
	  		  	A4230	  	A4230	  		  	Infusion set for external insulin pump, non-needle cannula Type	  	***	  		  	
	 HME
	  		  	A4231	  	A4231	  		  	Infusion set for external insulin pump, needle type	  	***	  		  	
	 HME
	  		  	A4232	  	A4232	  		  	Reservoir/Syringe with needle for external insulin pump	  	***	  		  	
	 HME
	  		  	A4632	  	A4632	  		  	Replacement battery for external insulin pump, any type, each	  	***	  		  	
	 HME
	  		  	A5119	  	A5119	  		  	Skin Barrier, wipes, box per 50	  	***	  		  	
	 HME
	  		  	A6257	  	A6257	  		  	Transparent film/dressing	  	***	  		  	
	 HME
	  	INSULPP	  	E0784	  	E0784	  	2158	  	PUMP (E0784), EXT AMBULATORY INFUSION, MINIMED, INSULIN	  	***	  		  	
	 HME
	  	INSULPP	  	E0784	  	E0784	  	8563	  	PUMP DISETRONIC ACCU-CHEK SPIRIT, INSULIN (E0784)	  	***	  		  	
	 HME
	  	INSULPP	  	E0784	  	E0784	  	7704	  	PUMP, EXT INFUSION, DANA DIABECARE, INSULIN (E0784)	  	***	  		  	
	 HME
	  	INSULPP	  	E0784	  	E0784	  	7731	  	PUMP, EXT INFUSION, ANIMAS, INSULIN (E0784)	  	***	  		  	
	 HME
	  	INSULPP	  	E0784	  	E0784	  	7773	  	PUMP (E0784), EXT AMBULATORY INFUSION, DELTEC, INSULIN	  	***	  		  	
	 HME
	  	OTHER	  	E0746	  	DM570	  	2109	  	ELECTROMYOGRAPHY (EMG) (E0746), BIOFEEDBACK DEVICE	  	***	  	***	  	
	 HME
	  	OTHER	  	E0935	  	E0935	  	2125	  	PASSIVE MOTION (E0935) EXERCISE DEVICE	  		  		  	***
	 HME
	  	OTHER	  	E0935	  	E0935	  	2857	  	PASSIVE MOTION (E0935) EXERCISE DEVICE, HAND	  		  		  	***
	 HME
	  	OTHER	  	E0935	  	E0935	  	2858	  	PASSIVE MOTION (E0935) EXERCISE DEVICE, SHOULDER	  		  		  	***
	 HME
	  	OTHER	  	E0935	  	E0935	  	2859	  	PASSIVE MOTION (E0935) EXERCISE DEVICE, ANKLE	  		  		  	***
	 HME
	  	OTHER	  	E0935	  	E0935	  	2860	  	PASSIVE MOTION (E0935) EXERCISE DEVICE, ELBOW	  		  		  	***
	 HME
	  	OTHER	  	E0935	  	E0935	  	2861	  	PASSIVE MOTION (E0935) EXERCISE DEVICE, WRIST	  		  		  	***
	 HME
	  	OTHER	  	E1300	  	DM570	  	2062	  	WHIRLPOOL (E1300), PORT (OVERTUB TYPE)	  	***	  		  	
	 HME
	  	OTHER	  	E1310	  	DM570	  	2061	  	WHIRLPOOL (E1399), NON-PORT (BUILT-IN TYPE)	  	***	  		  	
	 HME
	  	OTHER	  	E1399	  	E1399	  	2327	  	DURABLE MEDICAL EQUIP (E1399), MISCELLANEOUS	  	***	  		  	
	 HME
	  	WDSUCT	  	K0538	  	DM570	  	6873	  	WOUND SUCTION DEVICE (K0538)	  		  		  	***
	 HME
	  	WDSUCT	  	K0539	  	DM570	  	7914	  	DRESSING SET, FOR WOUND SUCTION DEVICE (K0539)	  	***	  		  	
	 HME
	  	WDSUCT	  	K0540	  	DM570	  	7915	  	CANISTER SET, FOR WOUND SUCTION DEVICE (K0540)	  	***	  		  	
	
	 The following may be charged under extraordinary circumstances:

									
	 HME
	  	SUP	  	E1399	  	E1399	  	4551	  	LABOR/SERVICE/SHIPPING CHARGES	  	***	  		  	
	 HME
	  	SUP	  	E1399	  	E1399	  	2731	  	SHIPPING AND HANDLING FEES	  	***	  		  	
	
	 The following may be charged if over and above routine on rental equipment:

									
	 RESP
	  	EQUIP	  	E1350	  	E1350	  	2382	  	REPAIR OR NON-ROUTINE (E1350) SERVICE REQUIRING SKILL OF A TECH	  	***	  		  	
	 HME
	  	SUP	  	E1399	  	E1399	  	4552	  	MISCELLANEOUS SUPPLIES	  	***	  		  	***

 NOTES: 
  

	1.	Whether rental or purchase, rates include all shipping, labor and set-up. 

  

	2.	If item is rented, rates include all supplies to enable the equipment to function effectively with the exception Suction and CPM. Such exception supplies will be billed at ***.

  

	3.	If item is rented, rates include repair and maintenance costs. 

  

	***	Confidential Treatment Requested. 

 EXHIBIT A 
 GATEKEEPER PROGRAM ATTACHMENT - CAPITATION 
 SCHEDULE OF CAPITATION RATES 
 CAPITATION RATES EFFECTIVE 2/1/08 - 1/31/09 
 These
are the capitation rates that apply to services rendered to Patient Panel Participants enrolled in Gatekeeper Programs. A “Gatekeeper Program” means (i) a product that includes fully insured Standard HMO, Point of Service, or
Gatekeeper PPO benefits and which is underwritten by a licensed insurance company based on an experience rating methodology, or (ii) a self funded product which includes Standard HMO, Point of Service, or Gatekeeper PPO benefits. This
definition includes, but is not limited to, Participants covered under FlexCare plans insured/administered by Connecticut General Life Insurance Company. 
  

			
	 	  	CareCentrix
Home Health,
Infusion, DME/
HME
Capitation Rates
PMPM
	 All Gatekeeper (FlexCare) Capitated Affiliates
	  	***

 Capitation Rate Compensation Terms 
 The following rates are established for the provision of Home Care Services rendered to Program Participants covered under the HMO and Gatekeeper plans: 
  

			
	February 1, 2008 - January 31, 2009	  	*** per member per month
	February 1, 2009 - January 31, 2010	  	*** per member per month
	February 1, 2010 - January 31, 2011	  	*** per member per month

 The capitation rate listed avove will be allocated between HMO and Gatekeeper Program particiants in accordance
with established business practices. On or about February 1 of each year, the parties shall reconcile the allocation and settle any payment difference no later than February 28 of each calendar year. 
 If an outlier calcuation for *** demonstrates a patient per thousand (PPK) increase in excess of ***, (***), then MCA reserves the right to propose an *** pmpm outlier
adjustment. CIGNA may elect to accept this adjustment or *** and *** from this agreement. 
  

	***	Confidential Treatment Requested. 

 EXHIBIT A 
 GATEKEEPER PROGRAM ATTACHMENT - FEE FOR SERVICE 
 REIMBURSEMENT FOR OTHER SERVICES 

RATE AREA DESIGNATIONS: 
  

					
	 STATE
	 	 RATE AREA
	 	 RATE DESIGNATION

	 Alabama
	 	***	 	***
	 Alaska
	 	***	 	***
	 Arizona
	 	***	 	***
	 Arkansas
	 	***	 	***
	 California
	 	***	 	***
	 Colorado
	 	***	 	***
	 Connecticut
	 	***	 	***
	 Delaware
	 	***	 	***
	 District of Columbia
	 	***	 	***
	 Florida
	 	***	 	***
	 Georgia
	 	***	 	***
	 Hawaii
	 	***	 	***
	 Idaho
	 	***	 	***
	 Illinois
	 	***	 	***
	 Indiana
	 	***	 	***
	 Iowa
	 	***	 	***
	 Kansas
	 	***	 	***
	 Kentucky
	 	***	 	***
	 Louisiana
	 	***	 	***
	 Maine
	 	***	 	***
	 Maryland
	 	***	 	***
	 Massachusetts
	 	***	 	***
	 Michigan
	 	***	 	***
	 Minnesota
	 	***	 	***
	 Mississippi
	 	***	 	***
	 Missouri
	 	***	 	***
	 Montana
	 	***	 	***
	 Nebraska
	 	***	 	***
	 Nevada
	 	***	 	***
	 New Hampshire
	 	***	 	***
	 New Jersey
	 	***	 	***
	 New Mexico
	 	***	 	***
	 New York
	 	***	 	***
	 North Carolina
	 	***	 	***
	 North Dakota
	 	***	 	***
	 Ohio
	 	***	 	***
	 Oklahoma
	 	***	 	***
	 Oregon
	 	***	 	***
	 Pennsylvania
	 	***	 	***
	 Rhode Island
	 	***	 	***
	 South Carolina
	 	***	 	***
	 South Dakota
	 	***	 	***
	 Tennessee
	 	***	 	***
	 Texas
	 	***	 	***
	 Utah
	 	***	 	***
	 Vermont
	 	***	 	***
	 Virginia
	 	***	 	***
	 Washington
	 	***	 	***
	 West Virginia
	 	***	 	***
	 Wisconsin
	 	***	 	***
	 Wyoming
	 	***	 	***

  

	***	Confidential Treatment Requested. 

 TRADITIONAL HOME HEALTH FEE-FOR-SERVICE RATES 
 GATEKEEPER RATES EFFECTIVE FEBRUARY 1, 2008 - JANUARY 31, 2009 
 The following Traditional Home Health Services have both Visit and Hourly rates. 
  

													
	 Notes 1, 2, 3, 4, 5 and 6 apply
	  	 Area 1
	  	 Area 2
	  	 Area 3

	  	 Visit
	  	 Hour
	  	 Visit
	  	 Hour
	  	 Visit
	  	 Hour

	 CERTIFIED NURSES AIDE
	  	***	  	***	  	***	  	***	  	***	  	***
	 HOME HEALTH AIDE
	  	***	  	***	  	***	  	***	  	***	  	***
	 LVN/LPN
	  	***	  	***	  	***	  	***	  	***	  	***
	 LVN/LPN—HIGH TECH
	  	***	  	***	  	***	  	***	  	***	  	***
	 PEDIATRIC HIGH TECH LVN/LPN
	  	***	  	***	  	***	  	***	  	***	  	***
	 PEDIATRIC HIGH TECH RN
	  	***	  	***	  	***	  	***	  	***	  	***
	 PEDIATRIC LVN/LPN
	  	***	  	***	  	***	  	***	  	***	  	***
	 PEDIATRIC RN
	  	***	  	***	  	***	  	***	  	***	  	***
	 RN
	  	***	  	***	  	***	  	***	  	***	  	***
	 RN HIGH TECH INFUSION
	  	***	  	***	  	***	  	***	  	***	  	***
	 RN HIGH TECH OTHER
	  	***	  	***	  	***	  	***	  	***	  	***
							
	The following Traditional Home Health Services have Visit only rates.	  		  		  		  		  		  	
				
	 Notes 1, 3, 4, 5, 7 and 8 apply
	  	 Area 1
	  	 Area 2
	  	 Area 3

	  	 Visit
	  	 Hour
	  	 Visit
	  	 Hour
	  	 Visit
	  	 Hour

	 DIABETIC NURSE
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 DIETITIAN
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 ENTEROSTOMAL THERAPIST
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 MATERNAL CHILD HEALTH
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 MEDICAL SOCIAL WORKER
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 OCCUPATIONAL THERAPIST
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 OCCUPATIONAL THERAPIST ASSISTANT
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 PHLEBOTOMIST
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 PHOTOTHERAPY PACKAGE SERVICE
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 PHYSICAL THERAPIST
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 PHYSICAL THERAPIST ASSISTANT
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 PSYCHIATRIC NURSE
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 REHABILITATION NURSE
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 RESPIRATORY THERAPIST
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 RN ASSESSMENT, INITIAL
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 RN SKILLED NURSING VISIT-EXTENSIVE
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 SPEECH THERAPIST
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 WOUND CARE—RN
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 WOUND CARE—LVN/LPN
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	
	The following Traditional Home Health Service has Hourly only rates.
				
	 Notes 3, 4 and 5 apply
	  	 Area 1
	  	 Area 2
	  	 Area 3

	  	 Visit
	  	 Hour
	  	 Visit
	  	 Hour
	  	 Visit
	  	 Hour

							
	 HOMEMAKER
	  	N/A	  	***	  	N/A	  	***	  	N/A	  	***
	
	The following Traditional Home Health Service is priced on a Per Diem basis.
				
	 Notes 3, 4 and 5 apply
	  	 Area 1
	  	 Area 2
	  	 Area 3

	  	 	  	 Per
 Diem
	  	 	  	 Per
 Diem
	  	 	  	 Per
Diem

	COMPANION/LIVE IN	  		  	***	  		  	***	  		  	***

 NOTES: 
  

	1.	Visits are defined as two (2) hours or less in duration (EXCEPT MATERNAL CHILD HEALTH VISITS, which have no maximum duration). 

  

	2.	Hourly rate for visits exceeding two (2) hours in duration, starting with hour 3. 

  

	3.	CIGNA does not reimburse for travel time, weekend, holiday or evening differentials. 

  

	4.	Above prices have no exclusions. 

  

	5.	All services not listed above will be billed at *** until rates are mutually established and become part of the fee schedule. 

  

	6.	RN High Tech Infusion visit and hourly utilization/costs to be reported with HIT. 

  

	7.	Respiratory Therapist visit utilization/costs to be reported with HME/RT. 

  

	8.	Diabetic Nurse, Psychiatric Nurse and Rehabilitation Nurse assume specialty certification which is not readily available in the home care environment. Use requires special
coordination. 

  

	***	Confidential Treatment Requested. 

 TRADITIONAL HOME HEALTH FEE-FOR-SERVICE RATES 
 GATEKEEPER RATES EFFECTIVE FEBRUARY 1, 2009 - JANUARY 31, 2010 
 The following Traditional Home Health Services have both Visit and Hourly rates. 
  

													
	  	  	 Area 1
	  	 Area 2
	  	 Area 3

	 Notes 1, 2, 3, 4, 5 and 6 apply
	  	 Visit
	  	 Hour
	  	 Visit
	  	 Hour
	  	 Visit
	  	 Hour

	 CERTIFIED NURSES AIDE
	  	***	  	***	  	***	  	***	  	***	  	***
	 HOME HEALTH AIDE
	  	***	  	***	  	***	  	***	  	***	  	***
	 LVN/LPN
	  	***	  	***	  	***	  	***	  	***	  	***
	 LVN/LPN—HIGH TECH
	  	***	  	***	  	***	  	***	  	***	  	***
	 PEDIATRIC HIGH TECH LVN/LPN
	  	***	  	***	  	***	  	***	  	***	  	***
	 PEDIATRIC HIGH TECH RN
	  	***	  	***	  	***	  	***	  	***	  	***
	 PEDIATRIC LVN/LPN
	  	***	  	***	  	***	  	***	  	***	  	***
	 PEDIATRIC RN
	  	***	  	***	  	***	  	***	  	***	  	***
	 RN
	  	***	  	***	  	***	  	***	  	***	  	***
	 RN HIGH TECH INFUSION
	  	***	  	***	  	***	  	***	  	***	  	***
	 RN HIGH TECH OTHER
	  	***	  	***	  	***	  	***	  	***	  	***
	
	The following Traditional Home Health Services have Visit only rates.
				
	  	  	 Area 1
	  	 Area 2
	  	 Area 3

	 Notes 1, 3, 4, 5, 7 and 8 apply
	  	 Visit
	  	 Hour
	  	 Visit
	  	 Hour
	  	 Visit
	  	 Hour

	 DIABETIC NURSE
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 DIETITIAN
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 ENTEROSTOMAL THERAPIST
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 MATERNAL CHILD HEALTH
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 MEDICAL SOCIAL WORKER
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 OCCUPATIONAL THERAPIST
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 OCCUPATIONAL THERAPIST ASSISTANT
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 PHLEBOTOMIST
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 PHOTOTHERAPY PACKAGE SERVICE
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 PHYSICAL THERAPIST
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 PHYSICAL THERAPIST ASSISTANT
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 PSYCHIATRIC NURSE
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 REHABILITATION NURSE
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 RESPIRATORY THERAPIST
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 RN ASSESSMENT, INITIAL
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 RN SKILLED NURSING VISIT-EXTENSIVE
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 SPEECH THERAPIST
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 WOUND CARE—RN
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	 WOUND CARE—LVN/LPN
	  	***	  	N/A	  	***	  	N/A	  	***	  	N/A
	
	The following Traditional Home Health Service has Hourly only rates.
				
	  	  	 Area 1
	  	 Area 2
	  	 Area 3

	 Notes 3, 4 and 5 apply
	  	 Visit
	  	 Hour
	  	 Visit
	  	 Hour
	  	 Visit
	  	 Hour

							
	 HOMEMAKER
	  	N/A	  	***	  	N/A	  	***	  	N/A	  	***
	
	The following Traditional Home Health Service is priced on a Per Diem basis.
				
	  	  	 Area 1
	  	 Area 2
	  	 Area 3

	 Notes 3, 4 and 5 apply
	  	 	  	 Per
 Diem
	  	 	  	 Per
 Diem
	  	 	  	 Per
Diem

							
	COMPANION/LIVE IN	  		  	***	  		  	***	  		  	***

 NOTES: 
  

	1.	Visits are defined as two (2) hours or less in duration (EXCEPT MATERNAL CHILD HEALTH VISITS, which have no maximum duration). 

  

	2.	Hourly rate for visits exceeding two (2) hours in duration, starting with hour 3. 

  

	3.	CIGNA does not reimburse for travel time, weekend, holiday or evening differentials. 

  

	4.	Above prices have no exclusions. 

  

	5.	All services not listed above will be billed at *** until rates are mutually established and become part of the fee schedule. 

  

	6.	RN High Tech Infusion visit and hourly utilization/costs to be reported with HIT. 

  

	7.	Respiratory Therapist visit utilization/costs to be reported with HME/RT. 

  

	8.	Diabetic Nurse, Psychiatric Nurse and Rehabilitation Nurse assume specialty certification which is not readily available in the home care environment. Use requires special
coordination. 

  

	***	Confidential Treatment Requested. 

 TRADITIONAL HOME HEALTH FEE-FOR-SERVICE RATES 
 GATEKEEPER RATES EFFECTIVE FEBRUARY 1, 2010—JANUARY 31, 2011 
 The following Traditional Home Health Services have both Visit and Hourly rates. 
  

													
	 Notes 1, 2, 3, 4, 5 and 6 apply
	  	Area 1	 	Area 2	 	Area 3
	  	Visit	 	Hour	 	Visit	 	Hour	 	Visit	 	Hour
	 CERTIFIED NURSES AIDE
	  	***	 	***	 	***	 	***	 	***	 	***
	 HOME HEALTH AIDE
	  	***	 	***	 	***	 	***	 	***	 	***
	 LVN/LPN
	  	***	 	***	 	***	 	***	 	***	 	***
	 LVN/LPN—HIGH TECH
	  	***	 	***	 	***	 	***	 	***	 	***
	 PEDIATRIC HIGH TECH LVN/LPN
	  	***	 	***	 	***	 	***	 	***	 	***
	 PEDIATRIC HIGH TECH RN
	  	***	 	***	 	***	 	***	 	***	 	***
	 PEDIATRIC LVN/LPN
	  	***	 	***	 	***	 	***	 	***	 	***
	 PEDIATRIC RN
	  	***	 	***	 	***	 	***	 	***	 	***
	 RN
	  	***	 	***	 	***	 	***	 	***	 	***
	 RN HIGH TECH INFUSION
	  	***	 	***	 	***	 	***	 	***	 	***
	 RN HIGH TECH OTHER
	  	***	 	***	 	***	 	***	 	***	 	***
	
	The following Traditional Home Health Services have Visit only rates.
				
	 Notes 1, 3, 4, 5, 7 and 8 apply
	  	Area 1	 	Area 2	 	Area 3
	  	Visit	 	Hour	 	Visit	 	Hour	 	Visit	 	Hour
	 DIABETIC NURSE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 DIETITIAN
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 ENTEROSTOMAL THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 MATERNAL CHILD HEALTH
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 MEDICAL SOCIAL WORKER
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 OCCUPATIONAL THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 OCCUPATIONAL THERAPIST ASSISTANT
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PHLEBOTOMIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PHOTOTHERAPY PACKAGE SERVICE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PHYSICAL THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PHYSICAL THERAPIST ASSISTANT
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PSYCHIATRIC NURSE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 REHABILITATION NURSE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 RESPIRATORY THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 RN ASSESSMENT, INITIAL
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 RN SKILLED NURSING VISIT-EXTENSIVE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 SPEECH THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 WOUND CARE—RN
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 WOUND CARE—LVN/LPN
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	
	The following Traditional Home Health Service has Hourly only rates.
				
	 Notes 3, 4 and 5 apply
	  	Area 1	 	Area 2	 	Area 3
	  	Visit	 	Hour	 	Visit	 	Hour	 	Visit	 	Hour
	 HOMEMAKER
	  	N/A	 	***	 	N/A	 	***	 	N/A	 	***
	
	The following Traditional Home Health Service is priced on a Per Diem basis.
				
	 Notes 3, 4 and 5 apply
	  	Area 1	 	Area 2	 	Area 3
	  	 	 	Per
Diem	 	 	 	Per
Diem	 	 	 	Per
Diem
	 COMPANION/LIVE IN
	  		 	***	 		 	***	 		 	***

 NOTES: 
  

	1.	Visits are defined as two (2) hours or less in duration (EXCEPT MATERNAL CHILD HEALTH VISITS, which have no maximum duration). 

  

	2.	Hourly rate for visits exceeding two (2) hours in duration, starting with hour 3. 

  

	3.	CIGNA does not reimburse for travel time, weekend, holiday or evening differentials. 

  

	4.	Above prices have no exclusions. 

  

	5.	All services not listed above will be billed at *** until rates are mutually established and become part of the fee schedule. 

  

	6.	RN High Tech Infusion visit and hourly utilization/costs to be reported with HIT. 

  

	7.	Respiratory Therapist visit utilization/costs to be reported with HME/RT. 

  

	8.	Diabetic Nurse, Psychiatric Nurse and Rehabilitation Nurse assume specialty certification which is not readily available in the home care environment. Use requires special
coordination. 

  

	***	Confidential Treatment Requested. 

 HOME INFUSION RATES 
 GATEKEEPER RATES EFFECTIVE FEBRUARY 1, 2008—JANUARY 31, 2009 
 The following Home Infusion Therapy service
rates EXCLUDE drugs. Drugs are priced as a percentage discount off AWP (if applicable), and there is NO price difference between primary and multiple therapies 
  

							
	 	  	Primary or
Multiple Therapy
Per Diem	 	Primary or
Multiple Therapy
Dispensing Fee	 	Primary or
Multiple Therapy
Drug Discount off AWP
	 Ancillary Drugs
	  		 	***	 	***
	 Biological Response Modifiers
	  		 	***	 	***
	 Cardiac (Inotropic) Therapy
	  	***	 		 	***
	 Chelation Therapy
	  	***	 		 	***
	 Chemotherapy
	  	***	 		 	***
	 Enzyme Therapy
	  	***	 		 	***
	 Growth Hormone
	  		 	***	 	***
	 IV Immune Globulin
	  	***	 		 	***
	 Other Injectable Therapies
	  		 	***	 	***
	 Other Infusion Therapies
	  	***	 		 	***
	 Pain Management Therapy
	  	***	 		 	***
	 Steroid Therapy
	  	***	 		 	***
	 Thrombolytic (Anticoagulation) Therapy
	  	***	 		 	***
	 Synagis
	  		 	***	 	***
	 Remodulin Therapy
	  	***	 		 	***
	
	The following Home Infusion Therapy service rates EXCLUDE drugs. Drugs are priced as a percentage discount off AWP, and there IS a price difference between primary and multiple
anti-infective therapies
				
	 	  	Per Diem	 	 	 	Drug Discount Off AWP
	 Anti-Infectives—Primary Anti-Infective
	  	***	 		 	***
	 Anti-Infectives—Multiple Anti-Infective
	  	***	 		 	***
	
	The following Home Infusion Therapy service rate EXCLUDES drugs. Drugs are priced per vial, and there is NO price difference between primary and multiple anti-infective
therapies
				
	 	  	Primary or
Multiple Therapy
Per Diem	 	 	 	Cost of Drug
	 Flolan Therapy
	  	***	 		 	
	 Flolan 0.5 mg vial
	  		 		 	***
	 Flolan 1.5 mg vial
	  		 		 	***
	 Flolan diluent vial
	  		 		 	***
	
	The following Home Infusion Therapy service rates INCLUDE drugs, and there is NO price difference between primary and multiple therapies
	 	  	Primary or
Multiple Therapy
Per Diem	 	 	 	 
	 Hydration Therapy
	  	***	 		 	
	 Total Parenteral Nutrition
	  	***	 		 	

  

	***	Confidential Treatment Requested. 

 SCHEDULE 2A, PAGE 2: HOME INFUSION THERAPY GATEKEEPER FEE-FOR-SERVICE RATES 
 NOTES: 
  

	1.	Per Diems EXCLUDING drugs include all costs related to the therapy except the cost of drugs, including but not limited to facility overhead, supplies, delivery, professional labor
including compounding and monitoring, all nursing required, maintenance of specialized catheters, equipment/patient supplies, disposables, pumps, general and administrative expenses, etc. 

  

	2.	Per Diems INCLUDING drugs include ALL costs—including but not limited to cost of drugs, facility overhead, supplies, delivery, professional labor including compounding and
monitoring, all nursing required, maintenance of specialized catheters, equipment/patient supplies, disposables, pumps, general and administrative expenses, etc. 

  

	3.	“DISPENSING FEE” is defined as per each time the drug is dispensed by the home infusion provider. 

  

	4.	“PER DIEM” costs are the same for primary or multiple treatments for all drug categories, except ANTI-INFECTIVES. 

  

	5.	The per diem rate shall only be charged for those days the Participant receives medication. 

  

	6.	For home infusion pharmaceuticals not listed on fee schedule, *** will apply. 

  

	7.	All Medications are subject to MAC pricing, where applicable 

 The
following are for the stated item ONLY. Unless otherwise noted, nursing, supplies, etc. are NOT included. 
  

								
	 Blood Transfusion per Unit (Tubing, Filters)
	 		 		  	*	**
	 Catheter Care Per Diem
	 		 		  	*	**
	 Midline Insertion (Catheter & Supplies)
	 		 		  	*	**
	 PICC Line Insertion (Catheter & Supplies)
	 		 		  	*	**
	 Blood Product
	 		 		  	*	**

  

	***	Confidential Treatment Requested. 

 SCHEDULE 2A, PAGE 3: HOME INFUSION THERAPY GATEKEEPER FEE-FOR-SERVICE RATES 
 Factor Concentrates 
  

					
	 	  	Vial price	 	Unit Price
	Factor VII	  		 	
	 Novoseven 1200MCG Vial
	  	***	 	
	 Novoseven 4800MCG Vial
	  	***	 	
	 Novoseven in 1200MCG or 4800MCG QTY
	  		 	***
			
	Factor VIII (Recombinant)	  		 	
	 Recombinate
	  		 	***
	 Kogenate or Helixate
	  		 	***
	 Bioclate
	  		 	***
	 Helixate FS
	  		 	***
	 Kogenate FS
	  		 	***
	 Refacto
	  		 	***
	 Advate
	  		 	***
			
	Factor VIII (Monoclonal)	  		 	
	 Hemofil-M or A. R. C. Method M
	  		 	***
	 Monoclate P
	  		 	***
	 Monarc-M
	  		 	***
			
	Factor VIII (Other)	  		 	
	 Koate
	  		 	***
	 Humate
	  		 	***
	 Alphanate SDHT
	  		 	***
			
	Factor IX (Recombinant)	  		 	
	 BeneFix
	  		 	***
			
	Factor IX (Monoclonal/High Purity)	  		 	
	 Mononine
	  		 	***
	 Alphanine
	  		 	***
			
	Factor IX (Other)	  		 	
	 Konyne—80
	  		 	***
	 Proplex T
	  		 	***
	 Bebulin
	  		 	***
	 Profilnine SD
	  		 	***
			
	Anti-Inhibitor Complex	  		 	
	 Autoplex-T
	  		 	***
	 Feiba-VH
	  		 	***
	 Hyate-C
	  		 	***
			
	HEMOSTATIC AGENTS	  		 	
	 DDAVP—10ml vial
	  		 	***
	 Stimate —2.5ml vial
	  		 	***

 Above rates include all necessary ancillary supplies and waste disposal unit; 24-hour on-call clinical support;
home infusion monitoring system; product delivery nationwide; patient training, education, and evaluation 
  

	***	Confidential Treatment Requested. 

 HOME INFUSION RATES 
 GATEKEEPER RATES EFFECTIVE FEBRUARY 1, 2009—JANUARY 31, 2010 
 The following Home Infusion Therapy service
rates EXCLUDE drugs. Drugs are priced as a percentage discount off AWP (if applicable), and there is NO price difference between primary and multiple therapies 
  

							
	 	  	Primary or
Multiple Therapy
Per Diem	 	Primary or
Multiple Therapy
Dispensing Fee	 	Primary or
Multiple Therapy
Drug Discount off AWP
	 Ancillary Drugs
	  		 	***	 	***
	 Biological Response Modifiers
	  		 	***	 	***
	 Cardiac (Inotropic) Therapy
	  	***	 		 	***
	 Chelation Therapy
	  	***	 		 	***
	 Chemotherapy
	  	***	 		 	***
	 Enzyme Therapy
	  	***	 		 	***
	 Growth Hormone
	  		 	***	 	***
	 IV Immune Globulin
	  	***	 		 	***
	 Other Injectable Therapies
	  		 	***	 	***
	 Other Infusion Therapies
	  	***	 		 	***
	 Pain Management Therapy
	  	***	 		 	***
	 Steroid Therapy
	  	***	 		 	***
	 Thrombolytic (Anticoagulation) Therapy
	  	***	 		 	***
	 Synagis
	  		 	***	 	***
	 Remodulin Therapy
	  	***	 		 	***
	
	The following Home Infusion Therapy service rates EXCLUDE drugs. Drugs are priced as a percentage discount off AWP, and there IS a price difference between primary and multiple
anti-infective therapies
				
	 	  	Per Diem	 	 	 	Drug Discount Off AWP
	 Anti-Infectives—Primary Anti-Infective
	  	***	 		 	***
	 Anti-Infectives—Multiple Anti-Infective
	  	***	 		 	***
	
	The following Home Infusion Therapy service rate EXCLUDES drugs. Drugs are priced per vial, and there is NO price difference between primary and multiple anti-infective
therapies
				
	 	  	Primary or
Multiple Therapy
Per Diem	 	 	 	Cost of Drug
	 Flolan Therapy
	  	***	 		 	
	 Flolan 0.5 mg vial
	  		 		 	***
	 Flolan 1.5 mg vial
	  		 		 	***
	 Flolan diluent vial
	  		 		 	***
	
	The following Home Infusion Therapy service rates INCLUDE drugs, and there is NO price difference between primary and multiple therapies
				
	 	  	Primary or
Multiple Therapy
Per Diem	 	 	 	 
	 Hydration Therapy
	  	***	 		 	
	 Total Parenteral Nutrition
	  	***	 		 	

  

	***	Confidential Treatment Requested. 

 SCHEDULE 2A, PAGE 2: HOME INFUSION THERAPY GATEKEEPER FEE-FOR-SERVICE RATES 
 NOTES: 
  

	1.	Per Diems EXCLUDING drugs include all costs related to the therapy except the cost of drugs, including but not limited to facility overhead, supplies, delivery, professional labor
including compounding and monitoring, all nursing required, maintenance of specialized catheters, equipment/patient supplies, disposables, pumps, general and administrative expenses, etc. 

  

	2.	Per Diems INCLUDING drugs include ALL costs—including but not limited to cost of drugs, facility overhead, supplies, delivery, professional labor including compounding and
monitoring, all nursing required, maintenance of specialized catheters, equipment/patient supplies, disposables, pumps, general and administrative expenses, etc. 

  

	3.	“DISPENSING FEE” is defined as per each time the drug is dispensed by the home infusion provider. 

  

	4.	“PER DIEM” costs are the same for primary or multiple treatments for all drug categories, except ANTI-INFECTIVES. 

  

	5.	The per diem rate shall only be charged for those days the Participant receives medication. 

  

	6.	For home infusion pharmaceuticals not listed on fee schedule, *** will apply. 

  

	7.	All Medications are subject to MAC pricing, where applicable 

 The
following are for the stated item ONLY. Unless otherwise noted, nursing, supplies, etc. are NOT included. 
  

							
	 Blood Transfusion per Unit (Tubing, Filters)
	  		  		  	***
	 Catheter Care Per Diem
	  		  		  	***
	 Midline Insertion (Catheter & Supplies)
	  		  		  	***
	 PICC Line Insertion (Catheter & Supplies)
	  		  		  	***
	 Blood Product
	  		  		  	***

  

	***	Confidential Treatment Requested. 

 SCHEDULE 2A, PAGE 3: HOME INFUSION THERAPY GATEKEEPER FEE-FOR-SERVICE RATES 
 Factor Concentrates 
  

					
	 	  	Vial price	 	Unit Price
	 Factor VII
	  		 	
	 Novoseven 1200MCG Vial
	  	***	 	
	 Novoseven 4800MCG Vial
	  	***	 	
	 Novoseven in 1200MCG or 4800MCG QTY
	  		 	***
			
	 Factor VIII (Recombinant)
	  		 	
	 Recombinate
	  		 	***
	 Kogenate or Helixate
	  		 	***
	 Bioclate
	  		 	***
	 Helixate FS
	  		 	***
	 Kogenate FS
	  		 	***
	 Refacto
	  		 	***
	 Advate
	  		 	***
			
	 Factor VIII (Monoclonal)
	  		 	
	 Hemofil-M or A. R. C. Method M
	  		 	***
	 Monoclate P
	  		 	***
	 Monarc-M
	  		 	***
			
	 Factor VIII (Other)
	  		 	
	 Koate
	  		 	***
	 Humate
	  		 	***
	 Alphanate SDHT
	  		 	***
			
	 Factor IX (Recombinant)
	  		 	
	 BeneFix
	  		 	***
			
	 Factor IX (Monoclonal/High Purity)
	  		 	
	 Mononine
	  		 	***
	 Alphanine
	  		 	***
			
	 Factor IX (Other)
	  		 	
	 Konyne—80
	  		 	***
	 Proplex T
	  		 	***
	 Bebulin
	  		 	***
	 Profilnine SD
	  		 	***
			
	 Anti-Inhibitor Complex
	  		 	
	 Autoplex-T
	  		 	***
	 Feiba-VH
	  		 	***
	 Hyate-C
	  		 	***
			
	 HEMOSTATIC AGENTS
	  		 	
	 DDAVP—10ml vial
	  		 	***
	 Stimate —2.5ml vial
	  		 	***

 Above rates include all necessary ancillary supplies and waste disposal unit; 24-hour on-call clinical support;
home infusion monitoring system; product delivery nationwide; patient training, education, and evaluation 
  

	***	Confidential Treatment Requested. 

 HOME INFUSION RATES 
 GATEKEEPER RATES EFFECTIVE FEBRUARY 1, 2010—JANUARY 31, 2011 
 The following Home Infusion Therapy service
rates EXCLUDE drugs. Drugs are priced as a percentage discount off AWP (if applicable), and there is NO price difference between primary and multiple therapies 
  

							
	 	  	Primary or
Multiple Therapy
Per Diem	 	Primary or
Multiple Therapy
Dispensing Fee	 	Primary or
Multiple Therapy
Drug Discount off AWP
	 Ancillary Drugs
	  		 	***	 	***
	 Biological Response Modifiers
	  		 	***	 	***
	 Cardiac (Inotropic) Therapy
	  	***	 		 	***
	 Chelation Therapy
	  	***	 		 	***
	 Chemotherapy
	  	***	 		 	***
	 Enzyme Therapy
	  	***	 		 	***
	 Growth Hormone
	  		 	***	 	***
	 IV Immune Globulin
	  	***	 		 	***
	 Other Injectable Therapies
	  		 	***	 	***
	 Other Infusion Therapies
	  	***	 		 	***
	 Pain Management Therapy
	  	***	 		 	***
	 Steroid Therapy
	  	***	 		 	***
	 Thrombolytic (Anticoagulation) Therapy
	  	***	 		 	***
	 Synagis
	  		 	***	 	***
	 Remodulin Therapy
	  	***	 		 	***
	
	The following Home Infusion Therapy service rates EXCLUDE drugs. Drugs are priced as a percentage discount off AWP, and there IS a price difference between primary and multiple
anti-infective therapies
				
	 	  	Per Diem	 	 	 	Drug Discount Off
AWP
	 Anti-Infectives—Primary Anti-Infective
	  	***	 		 	***
	 Anti-Infectives—Multiple Anti-Infective
	  	***	 		 	***
	
	The following Home Infusion Therapy service rate EXCLUDES drugs. Drugs are priced per vial, and there is NO price difference between primary and multiple anti-infective
therapies
				
	 	  	Primary or
Multiple Therapy
Per Diem	 	 	 	Cost of Drug
	 Flolan Therapy
	  	***	 		 	
	 Flolan 0.5 mg vial
	  		 		 	***
	 Flolan 1.5 mg vial
	  		 		 	***
	 Flolan diluent vial
	  		 		 	***
	
	The following Home Infusion Therapy service rates INCLUDE drugs, and there is NO price difference between primary and multiple therapies
				
	 	  	Primary or
Multiple Therapy
Per Diem	 	 	 	 
	 Hydration Therapy
	  	***	 		 	
	 Total Parenteral Nutrition
	  	***	 		 	

  

	***	Confidential Treatment Requested. 

 SCHEDULE 2A, PAGE 2: HOME INFUSION THERAPY GATEKEEPER FEE-FOR-SERVICE RATES 
 NOTES: 
  

	1.	Per Diems EXCLUDING drugs include all costs related to the therapy except the cost of drugs, including but not limited to facility overhead, supplies, delivery, professional labor
including compounding and monitoring, all nursing required, maintenance of specialized catheters, equipment/patient supplies, disposables, pumps, general and administrative expenses, etc. 

  

	2.	Per Diems INCLUDING drugs include ALL costs—including but not limited to cost of drugs, facility overhead, supplies, delivery, professional labor including compounding and
monitoring, all nursing required, maintenance of specialized catheters, equipment/patient supplies, disposables, pumps, general and administrative expenses, etc. 

  

	3.	“DISPENSING FEE” is defined as per each time the drug is dispensed by the home infusion provider. 

  

	4.	“PER DIEM” costs are the same for primary or multiple treatments for all drug categories, except ANTI-INFECTIVES. 

  

	5.	The per diem rate shall only be charged for those days the Participant receives medication. 

  

	6.	For home infusion pharmaceuticals not listed on fee schedule, *** will apply. 

  

	7.	All Medications are subject to MAC pricing, where applicable 

 The
following are for the stated item ONLY. Unless otherwise noted, nursing, supplies, etc. are NOT included. 
  

							
	 Blood Transfusion per Unit (Tubing, Filters)
	  		  		  	***
	 Catheter Care Per Diem
	  		  		  	***
	 Midline Insertion (Catheter & Supplies)
	  		  		  	***
	 PICC Line Insertion (Catheter & Supplies)
	  		  		  	***
	 Blood Product
	  		  		  	***

  

	***	Confidential Treatment Requested. 

 SCHEDULE 2A, PAGE 3: HOME INFUSION THERAPY GATEKEEPER FEE-FOR-SERVICE RATES 
 Factor Concentrates 
  

					
	 	  	Vial price	 	Unit Price
	 Factor VII
	  		 	
	 Novoseven 1200MCG Vial
	  	***	 	
	 Novoseven 4800MCG Vial
	  	***	 	
	 Novoseven in 1200MCG or 4800MCG QTY
	  		 	***
			
	 Factor VIII (Recombinant)
	  		 	
	 Recombinate
	  		 	***
	 Kogenate or Helixate
	  		 	***
	 Bioclate
	  		 	***
	 Helixate FS
	  		 	***
	 Kogenate FS
	  		 	***
	 Refacto
	  		 	***
	 Advate
	  		 	***
			
	 Factor VIII (Monoclonal)
	  		 	
	 Hemofil-M or A. R. C. Method M
	  		 	***
	 Monoclate P
	  		 	***
	 Monarc-M
	  		 	***
			
	 Factor VIII (Other)
	  		 	
	 Koate
	  		 	***
	 Humate
	  		 	***
	 Alphanate SDHT
	  		 	***
			
	 Factor IX (Recombinant)
	  		 	
	 BeneFix
	  		 	***
			
	 Factor IX (Monoclonal/High Purity)
	  		 	
	 Mononine
	  		 	***
	 Alphanine
	  		 	***
			
	 Factor IX (Other)
	  		 	
	 Konyne—80
	  		 	***
	 Proplex T
	  		 	***
	 Bebulin
	  		 	***
	 Profilnine SD
	  		 	***
			
	 Anti-Inhibitor Complex
	  		 	
	 Autoplex-T
	  		 	***
	 Feiba-VH
	  		 	***
	 Hyate-C
	  		 	***
			
	 HEMOSTATIC AGENTS
	  		 	
	 DDAVP—10ml vial
	  		 	***
	 Stimate —2.5ml vial
	  		 	***

 Above rates include all necessary ancillary supplies and waste disposal unit; 24-hour on-call clinical support;
home infusion monitoring system; product delivery nationwide; patient training, education, and evaluation 
  

	***	Confidential Treatment Requested. 

 DME / HME RESPIRATORY RATES: 
 GATEKEEPER RATES EFFECTIVE FEBRUARY 1, 2008—JANUARY 31. 2011 
  

																	
	 CAT
	  	TYPE	  	HCPCS
CODE	  	CHC
CODE	  	CareCentrix
Code	  	 DESCRIPTION
	  	PURCHASE
PRICE	 	RENTAL
PRICE	 	DAILY
PRICE
	HME	  		  	A4230	  	A4230	  		  	Infusion set for external insulin pump, non-needle cannula Type	  	***	 		 	
	HME	  		  	A4231	  	A4231	  		  	Infusion set for external insulin pump, needle type	  	***	 		 	
	HME	  		  	A4232	  	A4232	  		  	Reservoir/Syringe with needle for external insulin pump	  	***	 		 	
	HME	  		  	A4632	  	A4632	  		  	Replacement battery for external insulin pump, any type, each	  	***	 		 	
	HME	  		  	A5119	  	A5119	  		  	Skin Barrier, wipes, box per 50	  	***	 		 	
	HME	  		  	A6257	  	A6257	  		  	Transparent film/dressing	  	***	 		 	
	HME	  	INSULPP	  	E0784	  	E0784	  	2158	  	PUMP (E0784), EXT AMBULATORY INFUSION, MINIMED, INSULIN	  	***	 		 	
	HME	  	INSULPP	  	E0784	  	E0784	  	8563	  	PUMP DISETRONIC ACCU-CHEK SPIRIT, INSULIN (E0784)	  	***	 		 	
	HME	  	INSULPP	  	E0784	  	E0784	  	7704	  	PUMP, EXT INFUSION, DANA DIABECARE, INSULIN (E0784)	  	***	 		 	
	HME	  	INSULPP	  	E0784	  	E0784	  	7731	  	PUMP, EXT INFUSION, ANIMAS, INSULIN (E0784)	  	***	 		 	
	HME	  	INSULPP	  	E0784	  	E0784	  	7773	  	PUMP (E0784), EXT AMBULATORY INFUSION, DELTEC, INSULIN	  	***	 		 	
	HME	  	OTHER	  	E0746	  	DM570	  	2109	  	ELECTROMYOGRAPHY (EMG) (E0746), BIOFEEDBACK DEVICE	  	***	 	***	 	
	HME	  	OTHER	  	E0935	  	E0935	  	2125	  	PASSIVE MOTION (E0935) EXERCISE DEVICE	  		 		 	***
	HME	  	OTHER	  	E0935	  	E0935	  	2857	  	PASSIVE MOTION (E0935) EXERCISE DEVICE, HAND	  		 		 	***
	HME	  	OTHER	  	E0935	  	E0935	  	2858	  	PASSIVE MOTION (E0935) EXERCISE DEVICE, SHOULDER	  		 		 	***
	HME	  	OTHER	  	E0935	  	E0935	  	2859	  	PASSIVE MOTION (E0935) EXERCISE DEVICE, ANKLE	  		 		 	***
	HME	  	OTHER	  	E0935	  	E0935	  	2860	  	PASSIVE MOTION (E0935) EXERCISE DEVICE, ELBOW	  		 		 	***
	HME	  	OTHER	  	E0935	  	E0935	  	2861	  	PASSIVE MOTION (E0935) EXERCISE DEVICE, WRIST	  		 		 	***
	HME	  	OTHER	  	E1300	  	DM570	  	2062	  	WHIRLPOOL (E1300), PORT (OVERTUB TYPE)	  	***	 		 	
	HME	  	OTHER	  	E1310	  	DM570	  	2061	  	WHIRLPOOL (E1399), NON-PORT (BUILT-IN TYPE)	  	***	 		 	
	HME	  	OTHER	  	E1399	  	E1399	  	2327	  	DURABLE MEDICAL EQUIP (E1399), MISCELLANEOUS	  	***	 		 	
	HME	  	WDSUCT	  	K0538	  	DM570	  	6873	  	WOUND SUCTION DEVICE (K0538)	  		 		 	***
	HME	  	WDSUCT	  	K0539	  	DM570	  	7914	  	DRESSING SET, FOR WOUND SUCTION DEVICE (K0539)	  	***	 		 	
	HME	  	WDSUCT	  	K0540	  	DM570	  	7915	  	CANISTER SET, FOR WOUND SUCTION DEVICE (K0540)	  	***	 		 	
	
	The following may be charged under extraordinary circumstances:
									
	HME	  	SUP	  	E1399	  	E1399	  	4551	  	LABOR/SERVICE/SHIPPING CHARGES	  	***	 		 	
	HME	  	SUP	  	E1399	  	E1399	  	2731	  	SHIPPING AND HANDLING FEES	  	***	 		 	
	
	The following may be charged if over and above routine on rental equipment:
									
	RESP	  	EQUIP	  	E1350	  	E1350	  	2382	  	REPAIR OR NON-ROUTINE (E1350) SERVICE REQUIRING SKILL OF A TECH	  	***	 		 	
	HME	  	SUP	  	E1399	  	E1399	  	4552	  	MISCELLANEOUS SUPPLIES	  	***	 		 	***

 NOTES: 
  

	1.	Whether rental or purchase, rates include all shipping, labor and set-up. 

  

	2.	If item is rented, rates include all supplies to enable the equipment to function effectively with the exception Suction and CPM. Such exception supplies will be billed at ***.

  

	3.	If item is rented, rates include repair and maintenance costs. 

  

	***	Confidential Treatment Requested. 

 EXHIBIT A 
 PPO & INDEMNITY PROGRAM ATTACHMENT—FEE FOR SERVICE 
 REIMBURSEMENT FOR OTHER SERVICES

 RATE AREA DESIGNATIONS: 
  

					
	 STATE
	 	 RATE AREA
	 	 RATE DESIGNATION

	 Alabama
	 	***	 	***
	 Alaska
	 	***	 	***
	 Arizona
	 	***	 	***
	 Arkansas
	 	***	 	***
	 California
	 	***	 	***
	 Colorado
	 	***	 	***
	 Connecticut
	 	***	 	***
	 Delaware
	 	***	 	***
	 District of Columbia
	 	***	 	***
	 Florida
	 	***	 	***
	 Georgia
	 	***	 	***
	 Hawaii
	 	***	 	***
	 Idaho
	 	***	 	***
	 Illinois
	 	***	 	***
	 Indiana
	 	***	 	***
	 Iowa
	 	***	 	***
	 Kansas
	 	***	 	***
	 Kentucky
	 	***	 	***
	 Louisiana
	 	***	 	***
	 Maine
	 	***	 	***
	 Maryland
	 	***	 	***
	 Massachusetts
	 	***	 	***
	 Michigan
	 	***	 	***
	 Minnesota
	 	***	 	***
	 Mississippi
	 	***	 	***
	 Missouri
	 	***	 	***
	 Montana
	 	***	 	***
	 Nebraska
	 	***	 	***
	 Nevada
	 	***	 	***
	 New Hampshire
	 	***	 	***
	 New Jersey
	 	***	 	***
	 New Mexico
	 	***	 	***
	 New York
	 	***	 	***
	 North Carolina
	 	***	 	***
	 North Dakota
	 	***	 	***
	 Ohio
	 	***	 	***
	 Oklahoma
	 	***	 	***
	 Oregon
	 	***	 	***
	 Pennsylvania
	 	***	 	***
	 Rhode Island
	 	***	 	***
	 South Carolina
	 	***	 	***
	 South Dakota
	 	***	 	***
	 Tennessee
	 	***	 	***
	 Texas
	 	***	 	***
	 Utah
	 	***	 	***
	 Vermont
	 	***	 	***
	 Virginia
	 	***	 	***
	 Washington
	 	***	 	***
	 West Virginia
	 	***	 	***
	 Wisconsin
	 	***	 	***
	 Wyoming
	 	***	 	***

  

	***	Confidential Treatment Requested. 

 TRADITIONAL HOME HEALTH FEE-FOR-SERVICE RATES 
 PPO AND INDEMNITY RATES EFFECTIVE FEBRUARY 1, 2008—JANUARY 31, 2009 
 The following Traditional Home Health Services have both Visit and Hourly rates. 
  

													
	 Notes 1, 2, 3, 4, 5 and 6 apply
	  	Area 1	 	Area 2	 	Area 3
	  	Visit	 	Hour	 	Visit	 	Hour	 	Visit	 	Hour
	 CERTIFIED NURSES AIDE
	  	***	 	***	 	***	 	***	 	***	 	***
	 HOME HEALTH AIDE
	  	***	 	***	 	***	 	***	 	***	 	***
	 LVN/LPN
	  	***	 	***	 	***	 	***	 	***	 	***
	 LVN/LPN—HIGH TECH
	  	***	 	***	 	***	 	***	 	***	 	***
	 PEDIATRIC HIGH TECH LVN/LPN
	  	***	 	***	 	***	 	***	 	***	 	***
	 PEDIATRIC HIGH TECH RN
	  	***	 	***	 	***	 	***	 	***	 	***
	 PEDIATRIC LVN/LPN
	  	***	 	***	 	***	 	***	 	***	 	***
	 PEDIATRIC RN
	  	***	 	***	 	***	 	***	 	***	 	***
	 RN
	  	***	 	***	 	***	 	***	 	***	 	***
	 RN HIGH TECH INFUSION
	  	***	 	***	 	***	 	***	 	***	 	***
	 RN HIGH TECH OTHER
	  	***	 	***	 	***	 	***	 	***	 	***
	
	The following Traditional Home Health Services have Visit only rates.
				
	 Notes 1, 3, 4, 5, 7 and 8 apply
	  	Area 1	 	Area 2	 	Area 3
	  	Visit	 	Hour	 	Visit	 	Hour	 	Visit	 	Hour
	 DIABETIC NURSE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 DIETITIAN
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 ENTEROSTOMAL THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 MATERNAL CHILD HEALTH
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 MEDICAL SOCIAL WORKER
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 OCCUPATIONAL THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 OCCUPATIONAL THERAPIST ASSISTANT
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PHLEBOTOMIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PHOTOTHERAPY PACKAGE SERVICE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PHYSICAL THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PHYSICAL THERAPIST ASSISTANT
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PSYCHIATRIC NURSE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 REHABILITATION NURSE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 RESPIRATORY THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 RESPIRATORY THERAPIST—CPAP clinic
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 RN ASSESSMENT, INITIAL
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 RN SKILLED NURSING VISIT-EXTENSIVE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 SPEECH THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 WOUND CARE—RN
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 WOUND CARE—LVN/LPN
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	
	The following Traditional Home Health Service has Hourly only rates.
				
	 Notes 3, 4 and 5 apply
	  	Area 1	 	Area 2	 	Area 3
	  	Visit	 	Hour	 	Visit	 	Hour	 	Visit	 	Hour
	 HOMEMAKER
	  	N/A	 	***	 	N/A	 	***	 	N/A	 	***
	
	The following Traditional Home Health Service is priced on a Per Diem basis.
				
	 Notes 3, 4 and 5 apply
	  	Area 1	 	Area 2	 	Area 3
	  	 	 	Per
Diem	 	 	 	Per
Diem	 	 	 	Per
Diem
	 COMPANION/LIVE IN
	  		 	***	 		 	***	 		 	***

 NOTES: 
  

	1.	Visits are defined as two (2) hours or less in duration (EXCEPT MATERNAL CHILD HEALTH VISITS, which have no maximum duration). 

  

	2.	Hourly rate for visits exceeding two (2) hours in duration, starting with hour 3. 

  

	3.	CIGNA does not reimburse for travel time, weekend, holiday or evening differentials. 

  

	4.	Above prices have no exclusions. 

  

	5.	All services not listed above will be billed at *** until rates are mutually established and become part of the fee schedule. 

  

	6.	RN High Tech Infusion visit and hourly utilization/costs to be reported with HIT. 

  

	7.	Respiratory Therapist visit utilization/costs to be reported with HME/RT. 

  

	8.	Diabetic Nurse, Psychiatric Nurse and Rehabilitation Nurse assume specialty certification which is not readily available in the home care environment. Use requires special
coordination. 

  

	***	Confidential Treatment Requested. 

 TRADITIONAL HOME HEALTH FEE-FOR-SERVICE RATES 
 PPO AND INDEMNITY RATES EFFECTIVE FEBRUARY 1, 2009—JANUARY 31, 2010 
 The following Traditional Home Health Services have both Visit and Hourly rates. 
  

													
	 Notes 1, 2, 3, 4, 5 and 6 apply
	  	Area 1	 	Area 2	 	Area 3
	  	Visit	 	Hour	 	Visit	 	Hour	 	Visit	 	Hour
	 CERTIFIED NURSES AIDE
	  	***	 	***	 	***	 	***	 	***	 	***
	 HOME HEALTH AIDE
	  	***	 	***	 	***	 	***	 	***	 	***
	 LVN/LPN
	  	***	 	***	 	***	 	***	 	***	 	***
	 LVN/LPN—HIGH TECH
	  	***	 	***	 	***	 	***	 	***	 	***
	 PEDIATRIC HIGH TECH LVN/LPN
	  	***	 	***	 	***	 	***	 	***	 	***
	 PEDIATRIC HIGH TECH RN
	  	***	 	***	 	***	 	***	 	***	 	***
	 PEDIATRIC LVN/LPN
	  	***	 	***	 	***	 	***	 	***	 	***
	 PEDIATRIC RN
	  	***	 	***	 	***	 	***	 	***	 	***
	 RN
	  	***	 	***	 	***	 	***	 	***	 	***
	 RN HIGH TECH INFUSION
	  	***	 	***	 	***	 	***	 	***	 	***
	 RN HIGH TECH OTHER
	  	***	 	***	 	***	 	***	 	***	 	***
	
	The following Traditional Home Health Services have Visit only rates.
				
	 Notes 1, 3, 4, 5, 7 and 8 apply
	  	Area 1	 	Area 2	 	Area 3
	  	Visit	 	Hour	 	Visit	 	Hour	 	Visit	 	Hour
	 DIABETIC NURSE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 DIETITIAN
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 ENTEROSTOMAL THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 MATERNAL CHILD HEALTH
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 MEDICAL SOCIAL WORKER
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 OCCUPATIONAL THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 OCCUPATIONAL THERAPIST ASSISTANT
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PHLEBOTOMIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PHOTOTHERAPY PACKAGE SERVICE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PHYSICAL THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PHYSICAL THERAPIST ASSISTANT
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PSYCHIATRIC NURSE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 REHABILITATION NURSE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 RESPIRATORY THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 RESPIRATORY THERAPIST—CPAP clinic
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 RN ASSESSMENT, INITIAL
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 RN SKILLED NURSING VISIT-EXTENSIVE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 SPEECH THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 WOUND CARE—RN
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 WOUND CARE—LVN/LPN
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	
	The following Traditional Home Health Service has Hourly only rates.
				
	 Notes 3, 4 and 5 apply
	  	Area 1	 	Area 2	 	Area 3
	  	Visit	 	Hour	 	Visit	 	Hour	 	Visit	 	Hour
	 HOMEMAKER
	  	N/A	 	***	 	N/A	 	***	 	N/A	 	***
	
	The following Traditional Home Health Service is priced on a Per Diem basis.
				
	 Notes 3, 4 and 5 apply
	  	Area 1	 	Area 2	 	Area 3
	  	 	 	Per
Diem	 	 	 	Per
Diem	 	 	 	Per
Diem
	 COMPANION/LIVE IN
	  		 	***	 		 	***	 		 	***

 NOTES: 
  

	1.	Visits are defined as two (2) hours or less in duration (EXCEPT MATERNAL CHILD HEALTH VISITS, which have no maximum duration). 

  

	2.	Hourly rate for visits exceeding two (2) hours in duration, starting with hour 3. 

  

	3.	CIGNA does not reimburse for travel time, weekend, holiday or evening differentials. 

  

	4.	Above prices have no exclusions. 

  

	5.	All services not listed above will be billed at *** until rates are mutually established and become part of the fee schedule. 

  

	6.	RN High Tech Infusion visit and hourly utilization/costs to be reported with HIT. 

  

	7.	Respiratory Therapist visit utilization/costs to be reported with HME/RT. 

  

	8.	Diabetic Nurse, Psychiatric Nurse and Rehabilitation Nurse assume specialty certification which is not readily available in the home care environment. Use requires special
coordination. 

  

	***	Confidential Treatment Requested. 

 TRADITIONAL HOME HEALTH FEE-FOR-SERVICE RATES 
 PPO AND INDEMNITY RATES EFFECTIVE FEBRUARY 1, 2010—JANUARY 31. 2011 
 The following Traditional Home Health Services have both Visit and Hourly rates. 
  

													
	 Notes 1, 2, 3, 4, 5 and 6 apply
	  	Area 1	 	Area 2	 	Area 3
	  	Visit	 	Hour	 	Visit	 	Hour	 	Visit	 	Hour
	 CERTIFIED NURSES AIDE
	  	***	 	***	 	***	 	***	 	***	 	***
	 HOME HEALTH AIDE
	  	***	 	***	 	***	 	***	 	***	 	***
	 LVN/LPN
	  	***	 	***	 	***	 	***	 	***	 	***
	 LVN/LPN—HIGH TECH
	  	***	 	***	 	***	 	***	 	***	 	***
	 PEDIATRIC HIGH TECH LVN/LPN
	  	***	 	***	 	***	 	***	 	***	 	***
	 PEDIATRIC HIGH TECH RN
	  	***	 	***	 	***	 	***	 	***	 	***
	 PEDIATRIC LVN/LPN
	  	***	 	***	 	***	 	***	 	***	 	***
	 PEDIATRIC RN
	  	***	 	***	 	***	 	***	 	***	 	***
	 RN
	  	***	 	***	 	***	 	***	 	***	 	***
	 RN HIGH TECH INFUSION
	  	***	 	***	 	***	 	***	 	***	 	***
	 RN HIGH TECH OTHER
	  	***	 	***	 	***	 	***	 	***	 	***
	
	The following Traditional Home Health Services have Visit only rates.
				
	 Notes 1, 3, 4, 5, 7 and 8 apply
	  	Area 1	 	Area 2	 	Area 3
	  	Visit	 	Hour	 	Visit	 	Hour	 	Visit	 	Hour
	 DIABETIC NURSE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 DIETITIAN
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 ENTEROSTOMAL THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 MATERNAL CHILD HEALTH
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 MEDICAL SOCIAL WORKER
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 OCCUPATIONAL THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 OCCUPATIONAL THERAPIST ASSISTANT
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PHLEBOTOMIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PHOTOTHERAPY PACKAGE SERVICE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PHYSICAL THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PHYSICAL THERAPIST ASSISTANT
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 PSYCHIATRIC NURSE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 REHABILITATION NURSE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 RESPIRATORY THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 RESPIRATORY THERAPIST—CPAP clinic
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 RN ASSESSMENT, INITIAL
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 RN SKILLED NURSING VISIT-EXTENSIVE
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 SPEECH THERAPIST
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 WOUND CARE—RN
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	 WOUND CARE—LVN/LPN
	  	***	 	N/A	 	***	 	N/A	 	***	 	N/A
	
	The following Traditional Home Health Service has Hourly only rates.
				
	 Notes 3, 4 and 5 apply
	  	Area 1	 	Area 2	 	Area 3
	  	Visit	 	Hour	 	Visit	 	Hour	 	Visit	 	Hour
	 HOMEMAKER
	  	N/A	 	***	 	N/A	 	***	 	N/A	 	***
	
	The following Traditional Home Health Service is priced on a Per Diem basis.
				
	 Notes 3, 4 and 5 apply
	  	Area 1	 	Area 2	 	Area 3
	  	 	 	Per
Diem	 	 	 	Per
Diem	 	 	 	Per
Diem
	 COMPANION/LIVE IN
	  		 	***	 		 	***	 		 	***

 NOTES: 
  

	1.	Visits are defined as two (2) hours or less in duration (EXCEPT MATERNAL CHILD HEALTH VISITS, which have no maximum duration). 

  

	2.	Hourly rate for visits exceeding two (2) hours in duration, starting with hour 3. 

  

	3.	CIGNA does not reimburse for travel time, weekend, holiday or evening differentials. 

  

	4.	Above prices have no exclusions. 

  

	5.	All services not listed above will be billed at *** until rates are mutually established and become part of the fee schedule. 

  

	6.	RN High Tech Infusion visit and hourly utilization/costs to be reported with HIT. 

  

	7.	Respiratory Therapist visit utilization/costs to be reported with HME/RT. 

  

	8.	Diabetic Nurse, Psychiatric Nurse and Rehabilitation Nurse assume specialty certification which is not readily available in the home care environment. Use requires special
coordination. 

  

	***	Confidential Treatment Requested. 

 HOME INFUSION RATES 
 PPO AND INDEMNITY RATES EFFECTIVE FEBRUARY 1, 2008—JANUARY 31, 2009 
 The following Home Infusion Therapy
service rates EXCLUDE drugs. Drugs are priced as a percentage discount off AWP (if applicable), and there is NO price difference between primary and multiple therapies 
  

							
	 	  	Primary or
Multiple Therapy
Per Diem	 	Primary or
Multiple Therapy
Dispensing Fee	 	Primary or
Multiple Therapy
Drug Discount off AWP
	 Ancillary Drugs
	  		 	***	 	***
	 Biological Response Modifiers
	  		 	***	 	***
	 Cardiac (Inotropic) Therapy
	  	***	 		 	***
	 Chelation Therapy
	  	***	 		 	***
	 Chemotherapy
	  	***	 		 	***
	 Enzyme Therapy
	  	***	 		 	***
	 Growth Hormone
	  		 	***	 	***
	 IV Immune Globulin
	  	***	 		 	***
	 Other Injectable Therapies
	  		 	***	 	***
	 Other Infusion Therapies
	  	***	 		 	***
	 Pain Management Therapy
	  	***	 		 	***
	 Steroid Therapy
	  	***	 		 	***
	 Thrombolytic (Anticoagulation) Therapy
	  	***	 		 	***
	 Synagis
	  		 	***	 	***
	 Remodulin Therapy
	  	***	 		 	***
	
	The following Home Infusion Therapy service rates EXCLUDE drugs. Drugs are priced as a percentage discount off AWP, and there IS a price difference between primary and multiple
anti-infective therapies
				
	 	  	Per Diem	 	 	 	Drug Discount Off AWP
	 Anti-Infectives—Primary Anti-Infective
	  	***	 		 	***
	 Anti-Infectives—Multiple Anti-Infective
	  	***	 		 	***
	
	The following Home Infusion Therapy service rate EXCLUDES drugs. Drugs are priced per vial, and there is NO price difference between primary and multiple anti-infective
therapies
				
	 	  	Primary or
Multiple Therapy
Per Diem	 	 	 	Cost of Drug
	 Flolan Therapy
	  	***	 		 	
	 Flolan 0.5 mg vial
	  		 		 	***
	 Flolan 1.5 mg vial
	  		 		 	***
	 Flolan diluent vial
	  		 		 	***
	
	The following Home Infusion Therapy service rates INCLUDE drugs, and there is NO price difference between primary and multiple therapies
	 	  	Primary or
Multiple Therapy
Per Diem	 	 	 	 
	 Hydration Therapy
	  	***	 		 	
	 Total Parenteral Nutrition
	  	***	 		 	

  

	***	Confidential Treatment Requested. 

 SCHEDULE 2A, PAGE 2: HOME INFUSION THERAPY PPO & INDEMNITY FEE-FOR-SERVICE RATES

 NOTES: 
  

	1.	Per Diems EXCLUDING drugs include all costs related to the therapy except the cost of drugs, including but not limited to facility overhead, supplies, delivery, professional labor
including compounding and monitoring, all nursing required, maintenance of specialized catheters, equipment/patient supplies, disposables, pumps, general and administrative expenses, etc. 

  

	2.	Per Diems INCLUDING drugs include ALL costs—including but not limited to cost of drugs, facility overhead, supplies, delivery, professional labor including compounding and
monitoring, all nursing required, maintenance of specialized catheters, equipment/patient supplies, disposables, pumps, general and administrative expenses, etc. 

  

	3.	“DISPENSING FEE” is defined as per each time the drug is dispensed by the home infusion provider. 

  

	4.	“PER DIEM” costs are the same for primary or multiple treatments for all drug categories, except ANTI-INFECTIVES. 

  

	5.	The per diem rate shall only be charged for those days the Participant receives medication. 

  

	6.	For home infusion pharmaceuticals not listed on fee schedule, *** will apply. 

  

	7.	All Medications are subject to MAC pricing, where applicable. 

 The
following are for the stated item ONLY. Unless otherwise noted, nursing, supplies, etc. are NOT included. 
  

								
	 Blood Transfusion per Unit (Tubing, Filters)
	  		  		  	*	**
	 Catheter Care Per Diem
	  		  		  	*	**
	 Midline Insertion (Catheter & Supplies)
	  		  		  	*	**
	 PICC Line Insertion (Catheter & Supplies)
	  		  		  	*	**
	 Blood Product
	  		  		  	*	**

  

	***	Confidential Treatment Requested. 

 SCHEDULE 2A, PAGE 3: HOME INFUSION THERAPY PPO & INDEMNITY FEE-FOR-SERVICE RATES

 Factor Concentrates 
  

							
	 	  	 	  	Vial price	 	Unit Price
	 Factor VII
	  		  		 	
	 Novoseven 1200MCG Vial
	  		  	***	 	
	 Novoseven 4800MCG Vial
	  		  	***	 	
	 Novoseven in 1200MCG or 4800MCG QTY
	  		  		 	***
				
	 Factor VIII (Recombinant)
	  		  		 	
	 Recombinate
	  		  		 	***
	 Kogenate or Helixate
	  		  		 	***
	 Bioclate
	  		  		 	***
	 Helixate FS
	  		  		 	***
	 Kogenate FS
	  		  		 	***
	 Refacto
	  		  		 	***
	 Advate
	  		  		 	***
				
	 Factor VIII (Monoclonal)
	  		  		 	
	 Hemofil-M or A. R. C. Method M
	  		  		 	***
	 Monoclate P
	  		  		 	***
	 Monarc-M
	  		  		 	***
				
	 Factor VIII (Other)
	  		  		 	
	 Koate
	  		  		 	***
	 Humate
	  		  		 	***
	 Alphanate SDHT
	  		  		 	***
				
	 Factor IX (Recombinant)
	  		  		 	
	 BeneFix
	  		  		 	***
				
	 Factor IX (Monoclonal/High Purity)
	  		  		 	
	 Mononine
	  		  		 	***
	 Alphanine
	  		  		 	***
				
	 Factor IX (Other)
	  		  		 	
	 Konyne—80
	  		  		 	***
	 Proplex T
	  		  		 	***
	 Bebulin
	  		  		 	***
	 Profilnine SD
	  		  		 	***
				
	 Anti-Inhibitor Complex
	  		  		 	
	 Autoplex-T
	  		  		 	***
	 Feiba-VH
	  		  		 	***
	 Hyate-C
	  		  		 	***
				
	 HEMOSTATIC AGENTS
	  		  		 	
	 DDAVP—10ml vial
	  		  		 	***
	 Stimate —2.5ml vial
	  		  		 	***

 Above rates include all necessary ancillary supplies and waste disposal unit; 24-hour on-call clinical support;
home infusion monitoring system; product delivery nationwide; patient training, education, and evaluation 
  

	***	Confidential Treatment Requested. 

 HOME INFUSION RATES 
 PPO AND INDEMNITY RATES EFFECTIVE FEBRUARY 1, 2009—JANUARY 31. 2010 
 The following Home Infusion Therapy
service rates EXCLUDE drugs. Drugs are priced as a percentage discount off AWP (if applicable), and there is NO price difference between primary and multiple therapies 
  

							
	 	  	Primary or
Multiple Therapy
Per Diem	 	Primary or
Multiple Therapy
Dispensing Fee	 	Primary or
Multiple Therapy
Drug Discount off AWP
	 Ancillary Drugs
	  		 	***	 	***
	 Biological Response Modifiers
	  		 	***	 	***
	 Cardiac (Inotropic) Therapy
	  	***	 		 	***
	 Chelation Therapy
	  	***	 		 	***
	 Chemotherapy
	  	***	 		 	***
	 Enzyme Therapy
	  	***	 		 	***
	 Growth Hormone
	  		 	***	 	***
	 IV Immune Globulin
	  	***	 		 	***
	 Other Injectable Therapies
	  		 	***	 	***
	 Other Infusion Therapies
	  	***	 		 	***
	 Pain Management Therapy
	  	***	 		 	***
	 Steroid Therapy
	  	***	 		 	***
	 Thrombolytic (Anticoagulation) Therapy
	  	***	 		 	***
	 Synagis
	  		 	***	 	***
	 Remodulin Therapy
	  	***	 		 	***
	
	The following Home Infusion Therapy service rates EXCLUDE drugs. Drugs are priced as a percentage discount off AWP, and there IS a price difference between primary and multiple
anti-infective therapies
				
	 	  	Per Diem	 	 	 	Drug Discount Off AWP
	 Anti-Infectives—Primary Anti-Infective
	  	***	 		 	***
	 Anti-Infectives—Multiple Anti-Infective
	  	***	 		 	***
	
	The following Home Infusion Therapy service rate EXCLUDES drugs. Drugs are priced per vial, and there is NO price difference between primary and multiple anti-infective
therapies
				
	 	  	Primary or
Multiple Therapy
Per Diem	 	 	 	Cost of Drug
	 Flolan Therapy
	  	***	 		 	
	 Flolan 0.5 mg vial
	  		 		 	***
	 Flolan 1.5 mg vial
	  		 		 	***
	 Flolan diluent vial
	  		 		 	***
	
	The following Home Infusion Therapy service rates INCLUDE drugs, and there is NO price difference between primary and multiple therapies
				
	 	  	Primary or
Multiple Therapy
Per Diem	 	 	 	 
	 Hydration Therapy
	  	***	 		 	
	 Total Parenteral Nutrition
	  	***	 		 	

  

	***	Confidential Treatment Requested. 

 SCHEDULE 2A, PAGE 2: HOME INFUSION THERAPY PPO & INDEMNITY FEE-FOR-SERVICE RATES

 NOTES: 
  

	1.	Per Diems EXCLUDING drugs include all costs related to the therapy except the cost of drugs, including but not limited to facility overhead, supplies, delivery, professional labor
including compounding and monitoring, all nursing required, maintenance of specialized catheters, equipment/patient supplies, disposables, pumps, general and administrative expenses, etc. 

  

	2.	Per Diems INCLUDING drugs include ALL costs—including but not limited to cost of drugs, facility overhead, supplies, delivery, professional labor including compounding and
monitoring, all nursing required, maintenance of specialized catheters, equipment/patient supplies, disposables, pumps, general and administrative expenses, etc. 

  

	3.	“DISPENSING FEE” is defined as per each time the drug is dispensed by the home infusion provider. 

  

	4.	“PER DIEM” costs are the same for primary or multiple treatments for all drug categories, except ANTI-INFECTIVES. 

  

	5.	The per diem rate shall only be charged for those days the Participant receives medication. 

  

	6.	For home infusion pharmaceuticals not listed on fee schedule, *** will apply. 

  

	7.	All Medications are subject to MAC pricing, where applicable. 

 The
following are for the stated item ONLY. Unless otherwise noted, nursing, supplies, etc. are NOT included. 
  

								
	 Blood Transfusion per Unit (Tubing, Filters)
	  		  		  	*	**
	 Catheter Care Per Diem
	  		  		  	*	**
	 Midline Insertion (Catheter & Supplies)
	  		  		  	*	**
	 PICC Line Insertion (Catheter & Supplies)
	  		  		  	*	**
	 Blood Product
	  		  		  	*	**

  

	***	Confidential Treatment Requested. 

 SCHEDULE 2A, PAGE 3: HOME INFUSION THERAPY PPO & INDEMNITY FEE-FOR-SERVICE RATES

  

					
	 Factor Concentrates
	  		 	
			
	 	  	Vial price	 	Unit Price
	 Factor VII
	  		 	
	 Novoseven 1200MCG Vial
	  	***	 	
	 Novoseven 4800MCG Vial
	  	***	 	
	 Novoseven in 1200MCG or 4800MCG QTY
	  		 	***
			
	 Factor VIII (Recombinant)
	  		 	
	 Recombinate
	  		 	***
	 Kogenate or Helixate
	  		 	***
	 Bioclate
	  		 	***
	 Helixate FS
	  		 	***
	 Kogenate FS
	  		 	***
	 Refacto
	  		 	***
	 Advate
	  		 	***
			
	 Factor VIII (Monoclonal)
	  		 	
	 Hemofil-M or A. R. C. Method M
	  		 	***
	 Monoclate P
	  		 	***
	 Monarc-M
	  		 	***
			
	 Factor VIII (Other)
	  		 	
	 Koate
	  		 	***
	 Humate
	  		 	***
	 Alphanate SDHT
	  		 	***
			
	 Factor IX (Recombinant)
	  		 	
	 BeneFix
	  		 	***
			
	 Factor IX (Monoclonal/High Purity)
	  		 	
	 Mononine
	  		 	***
	 Alphanine
	  		 	***
			
	 Factor IX (Other)
	  		 	
	 Konyne—80
	  		 	***
	 Proplex T
	  		 	***
	 Bebulin
	  		 	***
	 Profilnine SD
	  		 	***
			
	 Anti-Inhibitor Complex
	  		 	
	 Autoplex-T
	  		 	***
	 Feiba-VH
	  		 	***
	 Hyate-C
	  		 	***
			
	 HEMOSTATIC AGENTS
	  		 	
	 DDAVP—10ml vial
	  		 	***
	 Stimate —2.5ml vial
	  		 	***
	Above rates include all necessary ancillary supplies and waste disposal unit; 24-hour on-call clinical support; home infusion monitoring system; product delivery nationwide; patient
training, education, and evaluation

  

	***	Confidential Treatment Requested. 

 HOME INFUSION RATES 
 PPO AND INDEMNITY RATES EFFECTIVE FEBRUARY 1, 2010—JANUARY 31, 2011 
 The following Home Infusion Therapy
service rates EXCLUDE drugs. Drugs are priced as a percentage discount off AWP (if applicable), and there is NO price difference between primary and multiple therapies 
  

							
	 	  	Primary or
Multiple Therapy
Per Diem	 	Primary or
Multiple Therapy
Dispensing Fee	 	Primary or
Multiple Therapy
Drug Discount off AWP
	 Ancillary Drugs
	  		 	***	 	***
	 Biological Response Modifiers
	  		 	***	 	***
	 Cardiac (Inotropic) Therapy
	  	***	 		 	***
	 Chelation Therapy
	  	***	 		 	***
	 Chemotherapy
	  	***	 		 	***
	 Enzyme Therapy
	  	***	 		 	***
	 Growth Hormone
	  		 	***	 	***
	 IV Immune Globulin
	  	***	 		 	***
	 Other Injectable Therapies
	  		 	***	 	***
	 Other Infusion Therapies
	  	***	 		 	***
	 Pain Management Therapy
	  	***	 		 	***
	 Steroid Therapy
	  	***	 		 	***
	 Thrombolytic (Anticoagulation) Therapy
	  	***	 		 	***
	 Synagis
	  		 	***	 	***
	 Remodulin Therapy
	  	***	 		 	***
	
	The following Home Infusion Therapy service rates EXCLUDE drugs. Drugs are priced as a percentage discount off AWP, and there IS a price difference between primary and multiple
anti-infective therapies
				
	 	  	Per Diem	 	 	 	Drug Discount Off AWP
	Anti-Infectives—Primary Anti-Infective	  	***	 		 	***
	Anti-Infectives—Multiple Anti-Infective	  	***	 		 	***
	
	The following Home Infusion Therapy service rate EXCLUDES drugs. Drugs are priced per vial, and there is NO price difference between primary and multiple anti-infective
therapies
				
	 	  	Primary or
Multiple Therapy
Per Diem	 	 	 	Cost of Drug
	 Flolan Therapy
	  	***	 		 	
	 Flolan 0.5 mg vial
	  		 		 	***
	 Flolan 1.5 mg vial
	  		 		 	***
	 Flolan diluent vial
	  		 		 	***
	
	The following Home Infusion Therapy service rates INCLUDE drugs, and there is NO price difference between primary and multiple therapies
	 	  	Primary or
Multiple Therapy
Per Diem	 	 	 	 
	 Hydration Therapy
	  	***	 		 	
	 Total Parenteral Nutrition
	  	***	 		 	

  

	***	Confidential Treatment Requested. 

 SCHEDULE 2A, PAGE 2: HOME INFUSION THERAPY PPO & INDEMNITY FEE-FOR-SERVICE RATES

 NOTES: 
  

	1.	Per Diems EXCLUDING drugs include all costs related to the therapy except the cost of drugs, including but not limited to facility overhead, supplies, delivery, professional labor
including compounding and monitoring, all nursing required, maintenance of specialized catheters, equipment/patient supplies, disposables, pumps, general and administrative expenses, etc. 

  

	2.	Per Diems INCLUDING drugs include ALL costs—including but not limited to cost of drugs, facility overhead, supplies, delivery, professional labor including compounding and
monitoring, all nursing required, maintenance of specialized catheters, equipment/patient supplies, disposables, pumps, general and administrative expenses, etc. 

  

	3.	“DISPENSING FEE” is defined as per each time the drug is dispensed by the home infusion provider. 

  

	4.	“PER DIEM” costs are the same for primary or multiple treatments for all drug categories, except ANTI-INFECTIVES. 

  

	5.	The per diem rate shall only be charged for those days the Participant receives medication. 

  

	6.	For home infusion pharmaceuticals not listed on fee schedule, *** will apply. 

  

	7.	All Medications are subject to MAC pricing, where applicable. 

 The
following are for the stated item ONLY. Unless otherwise noted, nursing, supplies, etc. are NOT included. 
  

								
	 Blood Transfusion per Unit (Tubing, Filters)
	  		  		  	*	**
	 Catheter Care Per Diem
	  		  		  	*	**
	 Midline Insertion (Catheter & Supplies)
	  		  		  	*	**
	 PICC Line Insertion (Catheter & Supplies)
	  		  		  	*	**
	 Blood Product
	  		  		  	*	**

  

	***	Confidential Treatment Requested. 

 SCHEDULE 2A, PAGE 3: HOME INFUSION THERAPY PPO & INDEMNITY FEE-FOR-SERVICE RATES

  

									
	 Factor Concentrates
	  		  			 		
				
	 	  	 	  	Vial price	 	 	Unit Price	 
	 Factor VII
	  		  			 		
	 Novoseven 1200MCG Vial
	  		  	*	**	 		
	 Novoseven 4800MCG Vial
	  		  	*	**	 		
	 Novoseven in 1200MCG or 4800MCG QTY
	  		  			 	*	**
				
	 Factor VIII (Recombinant)
	  		  			 		
	 Recombinate
	  		  			 	*	**
	 Kogenate or Helixate
	  		  			 	*	**
	 Bioclate
	  		  			 	*	**
	 Helixate FS
	  		  			 	*	**
	 Kogenate FS
	  		  			 	*	**
	 Refacto
	  		  			 	*	**
	 Advate
	  		  			 	*	**
				
	 Factor VIII (Monoclonal)
	  		  			 		
	 Hemofil-M or A. R. C. Method M
	  		  			 	*	**
	 Monoclate P
	  		  			 	*	**
	 Monarc-M
	  		  			 	*	**
				
	 Factor VIII (Other)
	  		  			 		
	 Koate
	  		  			 	*	**
	 Humate
	  		  			 	*	**
	 Alphanate SDHT
	  		  			 	*	**
				
	 Factor IX (Recombinant)
	  		  			 		
	 BeneFix
	  		  			 	*	**
				
	 Factor IX (Monoclonal/High Purity)
	  		  			 		
	 Mononine
	  		  			 	*	**
	 Alphanine
	  		  			 	*	**
				
	 Factor IX (Other)
	  		  			 		
	 Konyne—80
	  		  			 	*	**
	 Proplex T
	  		  			 	*	**
	 Bebulin
	  		  			 	*	**
	 Profilnine SD
	  		  			 	*	**
				
	 Anti-Inhibitor Complex
	  		  			 		
	 Autoplex-T
	  		  			 	*	**
	 Feiba-VH
	  		  			 	*	**
	 Hyate-C
	  		  			 	*	**
				
	 HEMOSTATIC AGENTS
	  		  			 		
	 DDAVP—10ml vial
	  		  			 	*	**
	 Stimate —2.5ml vial
	  		  			 	*	**
	
	Above rates include all necessary ancillary supplies and waste disposal unit; 24-hour on-call clinical support; home infusion monitoring system; product delivery nationwide; patient
training, education, and evaluation	  

  

	***	Confidential Treatment Requested. 

 DME / HME RESPIRATORY RATES: 
 PPO and INDEMNITY RATES EFFECTIVE FEBRUARY 1, 2008—JANUARY 31. 2011 
  

																	
	 CAT
	  	 TYPE
	  	 HCPCS
CODE
	  	 CHC
CODE
	  	 CareCentrix
Code
	  	 DESCRIPTION
	  	 PURCHASE
PRICE
	  	 RENTAL
PRICE
	  	 DAILY
PRICE

	 HME
	  		  	A4230	  	A4230	  		  	Infusion set for external insulin pump, non-needle cannula Type	  	***	  		  	
	 HME
	  		  	A4231	  	A4231	  		  	Infusion set for external insulin pump, needle type	  	***	  		  	
	 HME
	  		  	A4232	  	A4232	  		  	Reservoir/Syringe with needle for external insulin pump	  	***	  		  	
	 HME
	  		  	A4632	  	A4632	  		  	Replacement battery for external insulin pump, any type, each	  	***	  		  	
	 HME
	  		  	A5119	  	A5119	  		  	Skin Barrier, wipes, box per 50	  	***	  		  	
	 HME
	  		  	A6257	  	A6257	  		  	Transparent film/dressing	  	***	  		  	
	 HME
	  	INSULPP	  	E0784	  	E0784	  	2158	  	PUMP (E0784), EXT AMBULATORY INFUSION, MINIMED, INSULIN	  	***	  		  	
	 HME
	  	INSULPP	  	E0784	  	E0784	  	8563	  	PUMP DISETRONIC ACCU-CHEK SPIRIT, INSULIN (E0784)	  	***	  		  	
	 HME
	  	INSULPP	  	E0784	  	E0784	  	7704	  	PUMP, EXT INFUSION, DANA DIABECARE, INSULIN (E0784)	  	***	  		  	
	 HME
	  	INSULPP	  	E0784	  	E0784	  	7731	  	PUMP, EXT INFUSION, ANIMAS, INSULIN (E0784)	  	***	  		  	
	 HME
	  	INSULPP	  	E0784	  	E0784	  	7773	  	PUMP (E0784), EXT AMBULATORY INFUSION, DELTEC, INSULIN	  	***	  		  	
	 HME
	  	OTHER	  	E0746	  	DM570	  	2109	  	ELECTROMYOGRAPHY (EMG) (E0746), BIOFEEDBACK DEVICE	  	***	  	***	  	
	 HME
	  	OTHER	  	E0935	  	E0935	  	2125	  	PASSIVE MOTION (E0935) EXERCISE DEVICE	  		  		  	***
	 HME
	  	OTHER	  	E0935	  	E0935	  	2857	  	PASSIVE MOTION (E0935) EXERCISE DEVICE, HAND	  		  		  	***
	 HME
	  	OTHER	  	E0935	  	E0935	  	2858	  	PASSIVE MOTION (E0935) EXERCISE DEVICE, SHOULDER	  		  		  	***
	 HME
	  	OTHER	  	E0935	  	E0935	  	2859	  	PASSIVE MOTION (E0935) EXERCISE DEVICE, ANKLE	  		  		  	***
	 HME
	  	OTHER	  	E0935	  	E0935	  	2860	  	PASSIVE MOTION (E0935) EXERCISE DEVICE, ELBOW	  		  		  	***
	 HME
	  	OTHER	  	E0935	  	E0935	  	2861	  	PASSIVE MOTION (E0935) EXERCISE DEVICE, WRIST	  		  		  	***
	 HME
	  	OTHER	  	E1300	  	DM570	  	2062	  	WHIRLPOOL (E1300), PORT (OVERTUB TYPE)	  	***	  		  	
	 HME
	  	OTHER	  	E1310	  	DM570	  	2061	  	WHIRLPOOL (E1399), NON-PORT (BUILT-IN TYPE)	  	***	  		  	
	 HME
	  	OTHER	  	E1399	  	E1399	  	2327	  	DURABLE MEDICAL EQUIP (E1399), MISCELLANEOUS	  	***	  		  	
	 HME
	  	WDSUCT	  	K0538	  	DM570	  	6873	  	WOUND SUCTION DEVICE (K0538)	  		  		  	***
	 HME
	  	WDSUCT	  	K0539	  	DM570	  	7914	  	DRESSING SET, FOR WOUND SUCTION DEVICE (K0539)	  	***	  		  	
	 HME
	  	WDSUCT	  	K0540	  	DM570	  	7915	  	CANISTER SET, FOR WOUND SUCTION DEVICE (K0540)	  	***	  		  	
	
	 The following may be charged under extraordinary circumstances:

									
	HME	  	SUP	  	E1399	  	E1399	  	4551	  	LABOR/SERVICE/SHIPPING CHARGES	  	***	  		  	
	HME	  	SUP	  	E1399	  	E1399	  	2731	  	SHIPPING AND HANDLING FEES	  	***	  		  	
	
	 The following may be charged if over and above routine on rental equipment:

									
	 RESP
	  	EQUIP	  	E1350	  	E1350	  	2382	  	REPAIR OR NON-ROUTINE (E1350) SERVICE REQUIRING SKILL OF A TECH	  	***	  		  	
	 HME
	  	SUP	  	E1399	  	E1399	  	4552	  	MISCELLANEOUS SUPPLIES	  	***	  		  	***

 NOTES: 
  

	1.	Whether rental or purchase, rates include all shipping, labor and set-up. 

  

	2.	If item is rented, rates include all supplies to enable the equipment to function effectively with the exception Suction and CPM. Such exception supplies will be billed at ***.

  

	3.	If item is rented, rates include repair and maintenance costs. 

  
  

	***	Confidential Treatment Requested.Severance Agreement dated February 28, 2008 with Tony Strange

 EXHIBIT 10.4 
 February 28, 2008 
 Mr. Tony Strange 
 3655
Rivers Call Blvd. 
 Atlanta, GA 30339-8502 
 Dear Tony:

 In consideration of the mutual promises, covenants and obligations contained herein, this letter agreement (the “Letter
Agreement”) amends and restates the letter agreement between you and Gentiva Health Services, Inc. (the “Company”) dated February 28, 2006 (the “Original Letter Agreement”), which is superseded in its entirety by this
Letter Agreement; provided, however, that the Confidentiality, Non-Competition and Intellectual Property Agreement dated as of February 28, 2006 by and among you, the Company and The Healthfield Group, Inc. (the
“Confidentiality, Non-Competition and Intellectual Property Agreement”) shall remain in full force and effect. This amendment and restatement of the Original Letter Agreement is intended to bring it into compliance with Section 409A
of the Internal Revenue Code of 1986, as amended (the “Code”). 
  

	 	1.	Your employment with the Company will be as an employee at will. Your status as an officer of the Company will be determined by the Board of Directors of the Company in accordance
with the By-Laws of the Company. 

  

	 	2.	Your compensation (including bonus opportunity) shall be as set forth on Schedule 7.2(g) to the Agreement and Plan of Merger, dated as of January 4, 2006, by and among the
Company, Tara Acquisition Sub Corp., The Healthfield Group, Inc., Rodney D. Windley, as the representative for the Securityholders (as defined therein) of the Company, and the Securityholders named therein, as may be adjusted from time to time.

  

	 	 3.
	 Should the Company terminate your employment other than for cause (as hereinafter defined), the Company will pay to you,
subject to paragraph 7 below, on a bi-weekly basis (or other regular payroll cycle in use by the Company at the time your employment terminates), twelve (12) months of severance (the “Severance Period”), based on your then current
base salary; provided, however, that any such amount otherwise payable to you prior to sixty (60) days after such termination of employment shall be paid, subject to paragraph 7 below, on the sixtieth (60th) day following such termination of employment. In addition, your medical/prescriptions/dental/vision benefits will be continued until the end of the
Severance Period or until similar benefits become available to you from a new employer, whichever comes first. Such benefits continuation shall be on the same basis as if you had continued in the employ of the Company (e.g., including any
required associate contributions) during that period adjusted for any plan changes. The payment of severance, however, is expressly conditioned upon your compliance with the terms set forth in paragraph 5(b) of this Letter Agreement.

 The term “cause” shall mean the following: your conviction for any felony, fraud or
embezzlement or crime of moral turpitude; controlled substance abuse; alcoholism which interferes with or affects your responsibilities to the Company or which reflects negatively upon the integrity or reputation of the Company; gross negligence
which is materially injurious to the Company; any material violation of any express written directions or any reasonable written policy or procedure established by the Company from time to time regarding the conduct of its business and such
violation has not been cured within ten (10) days after written notice of such violation from the Company to you; or any violation by you of any material term and condition of this Letter Agreement. 
  

	 	4.	Upon a reduction in your current base salary, as the same may be increased from time to time, which is not part of a general salary reduction for a majority of salaried employees of
the Company and to which you do not consent in writing, you will have the right (subject to the notice and cure provisions below) to resign and receive the severance benefits described above, with your severance payments based on your salary prior
to it having been reduced. In order to exercise this right you must have given written notice to the Company of the reduction in base salary within sixty (60) days after it is so reduced, and the Company must not have remedied the base salary
reduction within the thirty (30) day period after receipt of such written notice; provided further, however, that any termination of employment by you under this paragraph 4 must occur not later than one (1) year
following the initial existence of the base salary reduction giving rise to your right to terminate under this paragraph 4. 

  

	 	5.	(a) Your employment with the Company and your receipt of stock options is expressly conditioned upon your consent and agreement to be bound by the non-competition and
non-solicitation provisions set forth in the Confidentiality, Non-Competition and Intellectual Property Agreement. 

 (b)
Further, should the Company terminate your employment other than for “cause” (as defined in paragraph 3 of this Letter Agreement) or should you terminate your employment pursuant to paragraph 4 above, you also agree that your receipt of
the severance payments and benefits provided for herein is expressly conditioned upon your consent and agreement to continue to be bound by the non-competition and non-solicitation provisions set forth in the Confidentiality, Non-Competition and
Intellectual Property Agreement and your execution and delivery within fifty (50) days after termination of your employment of, and your failure to revoke within the statutory revocation period, the General Release Agreement, the form of which
is attached hereto as Exhibit A. 
  

 -2- 

	 	6.	This Letter Agreement may be amended only by a written instrument signed by the Company and you. Except with respect to your Change in Control Agreement of even date with the
Company, the Merger Agreement and any other agreement between the Company and you specifically referenced herein and intended to continue beyond the execution of this Letter Agreement, this Letter Agreement shall constitute the entire agreement
between the Company and you with respect to the subject matter hereof and supersedes any other severance or separation pay plan or policy that would otherwise apply to you. Specifically, you and the Company have agreed that your employment agreement
dated December 10, 2001 between you and Healthfield, Inc. (“Employment Agreement”) has been terminated as of February 28, 2006 and is of no further force or effect. You have waived and released all rights you may have had under
the Employment Agreement. This Letter Agreement shall be governed by the laws of the State of New York, without regard to the principles of conflict of laws thereof. This Letter Agreement shall be binding upon and inure to the benefit of the parties
hereto and their respective successors, heirs (in your case) and assigns. 

  

	 	7.	It is intended that this Letter Agreement will comply with Section 409A of the Code (and any regulations and guidelines issued thereunder) to the extent the Letter Agreement is
subject thereto, and the Letter Agreement shall be interpreted on a basis consistent with such intent. If an amendment of the Letter Agreement is necessary in order for it to comply with Section 409A, the parties hereto will negotiate in good
faith to amend the Letter Agreement in a manner that preserves the original intent of the parties to the extent reasonably possible. Notwithstanding any provision to the contrary in this Letter Agreement, if you are deemed on the date of your
“separation from service” (within the meaning of Treas. Reg. Section 1.409A-1(h)) to be a “specified employee” (within the meaning of Treas. Reg. Section 1.409A-1(i)), then with regard to any payment that is required to
be delayed pursuant to Section 409A(a)(2)(B) of the Code, such payment shall not be made prior to the earlier of (i) the expiration of the six (6)-month period measured from the date of your “separation from service,” or
(ii) the date of your death (the “Delay Period”). Upon the expiration of the Delay Period, all payments delayed pursuant to this paragraph 7 (whether they would have otherwise been payable in a single sum or in installments in the
absence of such delay) shall be paid to you in a lump sum, and any remaining payments due under this Letter Agreement shall be paid in accordance with the normal payment dates specified for them herein. Notwithstanding any provision of this Letter
Agreement to the contrary, your employment will be deemed to have terminated on the date of your “separation from service” (within the meaning of Treas. Reg. Section 1.409A-1(h)) with the Company. Wherever payments under this Letter
Agreement are to be made in installments, each such installment shall be deemed to be a separate payment for purposes of Section 409A. No action or failure to act, pursuant to this paragraph 7 shall subject the Company to any claim, liability,
or expense, and the Company shall not have any obligation to indemnify or otherwise protect you from the obligation to pay any taxes pursuant to Section 409A of the Code. 

  

 -3- 

			
	Sincerely,
		
	By:	 	 /s/ Ronald A. Malone

		 	Ronald A. Malone
		 	Chairman and Chief Executive Officer

  

					
	Agreed to and Accepted by:	 		  	
			
	 /s/ Tony Strange
	 		  	4/30/08
	Tony Strange	 		  	Date

  

 -4- 

 Schedule 7.2 (g) 
 TERM SHEET 
 EMPLOYMENT ARRANGEMENTS FOR TONY STRANGE 
  

					
	1.	  	Title:	  	Executive Vice President of Gentiva and President of Home Health.
			
	2.	  	Base Salary	  	$425,000 annually.
			
	3.	  	Bonus Opportunity:	  	If targets are achieved, 60% of Base Salary; if targets are exceeded, greater than 60% of Base Salary.
			
	4.	  	Change of Control:	  	Same terms as other senior executives of Gentiva.
			
	5.	  	Severance:	  	12 months for termination other than for cause.
			
	6.	  	Stock Options:	  	Amount commensurate with his position as determined annually by the Compensation, Corporate Governance and Nominating Committees of the Board.
			
	7.	  	Other Benefits:	  	Commensurate with other senior executives of Gentiva.
			
	8.	  	Commencement of Employment:	  	Upon consummation of merger of The Healthfield Group, Inc. with a subsidiary of Gentiva.
			
	9.	  	Definition of Documentation:	  	Generally same terms as other senior executives of Gentiva in form previously provided.

 EXHIBIT A 
 GENERAL RELEASE 
 1) I, Tony Strange, understand that, in order to receive the severance package contained in
Section 3 of the Letter Agreement between Gentiva Health Services, Inc. and me dated as of February 28, 2008 (the “Letter Agreement”) which I would not otherwise receive or be entitled to, I have been requested to sign this
General Release. I further understand that by signing this General Release, I am waiving my right to raise any claims against Gentiva Health Services, Inc. (“Gentiva” or “the Company”) and other Releasees (as defined below) under
federal, state and/or local law. 
 2) General Release 
 I hereby agree to release and forever discharge the Company, its subsidiaries and affiliates, and its and their directors and officers, predecessors, employees, agents, successors and assigns (collectively
“Releasees”) from any and all actions or causes of action, suits, claims, charges, complaints, contracts and promises whatsoever, in law or equity which I, my heirs, assigns and any personal or legal representatives have or may have
against any of the Releasees including all unknown, undisclosed and unanticipated losses, wrongs, injuries, debts, claims and/or damages arising out of or in any way connected with my employment with the Company or its subsidiaries and the cessation
of such employment. This shall include but not be limited to any alleged violation of Title VII of the Civil Rights Act of 1964, Section 1981 et seq. of Title 42 of the United States Code, the Employee Retirement Income
Security Act of 1974, the Americans with Disabilities Act of 1990, the Age Discrimination in Employment Act of 1967, the Fair Labor Standards Act, the Occupational, Safety and Health Act, the New York Human Rights Law, Executive Law Section 290
et seq., the New York Labor Law, the New York Equal Rights Law Section 40 et seq., the New York Minimum Wage Law, the New York Equal Pay Law, each of the foregoing as amended, and any and all other Federal, State or
local civil or human rights laws, or any other alleged violation of any local, State or Federal law, regulation or ordinance, and/or public policy, contract or tort or common-law claim having any bearing whatsoever on the terms and conditions and/or
cessation of my employment with the Company and its subsidiaries which I now have or shall have as of the date of this General Release. 
 This General Release does not constitute a waiver of my right to bring action against the Company to enforce the terms and provisions of the Letter Agreement. 
 This General Release does not constitute a waiver of my prior indemnification rights, if any, should I be ordered to appear as a witness or made a defendant in any litigation regarding matters or actions taken within
the scope of my responsibilities as an employee of the Company. 

 3) Not A Waiver of Vested Benefits 
 This General Release shall not constitute a waiver of (i) right to benefits which have vested on or prior to the date of termination of my employment or the terms of any applicable employee benefit plan, or
(ii) my unreimbursed business expenses properly incurred prior to the date my employment was terminated in accordance with Company policy. 
 4)
Covenant Not to Sue 
 I agree that I will not file, charge (except that I may file a charge with the Equal Employment Opportunity
Commission alleging age discrimination), claim, sue or cause or permit to be filed any civil action, suit or legal proceeding seeking personal equitable or monetary relief for me in connection with any matter occurring at any time in the past
concerning my employment relationship with the Company, up to and including the date of this General Release, or involving any continuing effects of any acts or practices which may have arisen or occurred on or prior to the date of this General
Release. I further agree that should any person, organization, or other entity file, charge, claim, sue, or cause or permit to be filed any civil action, suit or legal proceeding involving any matter occurring at any time in the past, I will not
seek or accept any personal relief in such civil action, suit or legal proceeding. Nothing in this Section 4 shall limit my right to cooperate with the Equal Employment Opportunity Commission (“EEOC”) in an investigation of a charge
of age discrimination, including a charge filed with the EEOC filed by me. 
 5) Non-Disclosure of Terms 
 I hereby agree that I shall not directly or indirectly publish the terms or conditions of this General Release nor discuss or make any statements with
regard to such terms or conditions except to my personal lawyer or as required by law. 
 6) Governing Law and Interpretation 
 This General Release shall be governed by and construed in accordance with the laws of New York State without regard to its conflict of laws provisions.
Should any provision of this General Release be declared illegal or unenforceable by any court of competent jurisdiction, and cannot be modified to be enforceable, such provision shall immediately become null and void, leaving the remainder of this
General Release in full force and effect. However, if the release portion is held invalid or unenforceable by a court of competent jurisdiction or any governmental agency, or I exercise my right to rescind set forth in Section 8 below, then I
agree to immediately return to the Company any payment I received as part of the severance package and the Company shall have no further obligation under the Letter Agreement. 
 7) Entire Agreement; Amendment 
 This General Release and the Letter Agreement, along with the
Confidentiality, Non-Competition and Intellectual Property Agreement dated as of February 26, 2006 by and among me, the Company and The Healthfield Group, Inc., set forth the entire agreement between 

  

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the parties hereto and shall supersede any and all prior understandings between the parties, except to the extent as set forth in the Letter Agreement. This
General Release may not be amended except by a written agreement signed by both parties to the Letter Agreement. 
 8) Effective Date; Right to Revoke

 I understand that I have been provided the opportunity to review this General Release for a period of twenty-one (21) days. I
understand that this General Release shall not become effective or enforceable until the expiration of seven (7) days following the date on which I first execute this General Release. I also understand that I have the right to revoke this
General Release within seven (7) days of when I sign this General Release and that such revocation shall not be effective unless each of the following conditions has been met: 
 (a) the revocation is made in writing addressed to the Company and includes the statement, “I hereby revoke my agreement to the General Release and
the terms and conditions set forth in the Letter Agreement.” 
 (b) such written revocation is delivered either by hand to the office of
the General Counsel of Gentiva Health Services, Inc. or by mail with a postmark dated before the end of the seven (7) day revocation period, such mail to be certified, return receipt requested. 
 I HAVE READ AND CONSIDERED THE TERMS AND CONDITIONS CONTAINED IN THIS GENERAL RELEASE. I UNDERSTAND THAT MY RIGHT TO RECEIVE THE SEVERANCE PACKAGE IN ACCORDANCE WITH THE
LETTER AGREEMENT IS SUBJECT TO THE TERMS AND CONDITIONS SET FORTH IN THIS GENERAL RELEASE AND THAT I WOULD NOT RECEIVE SUCH BENEFIT BUT FOR MY EXECUTION OF THIS GENERAL RELEASE. I ALSO UNDERSTAND THAT BY EXECUTING THIS GENERAL RELEASE, I WILL BE
WAIVING MY RIGHTS UNDER FEDERAL, STATE AND LOCAL LAW TO BRING ANY CLAIMS THAT I HAVE OR MIGHT HAVE AGAINST ANY RELEASEES (AS DEFINED ABOVE). I HAVE BEEN AFFORDED AT LEAST TWENTY-ONE (21) DAYS TO CONSIDER THIS GENERAL RELEASE AND HAVE BEEN
ADVISED IN WRITING TO CONSULT WITH AN ATTORNEY PRIOR TO EXECUTING THIS GENERAL RELEASE. 
 IN WITNESS WHEREOF, I have executed this General
Release as of the date set forth below. 
  

			
	Signed:	 	  

		
	Date:	 	  

  

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