Attached files
| file | filename |
|---|---|
| 10-K - FORM 10-K - IASIS Healthcare LLC | c92860e10vk.htm |
| EX-10.15 - EXHIBIT 10.15 - IASIS Healthcare LLC | c92860exv10w15.htm |
| EX-10.13 - EXHIBIT 10.13 - IASIS Healthcare LLC | c92860exv10w13.htm |
| EX-10.11 - EXHIBIT 10.11 - IASIS Healthcare LLC | c92860exv10w11.htm |
| EX-10.17 - EXHIBIT 10.17 - IASIS Healthcare LLC | c92860exv10w17.htm |
| EX-10.12 - EXHIBIT 10.12 - IASIS Healthcare LLC | c92860exv10w12.htm |
| EX-21 - EXHIBIT 21 - IASIS Healthcare LLC | c92860exv21.htm |
| EX-31.2 - EXHIBIT 31.2 - IASIS Healthcare LLC | c92860exv31w2.htm |
| EX-31.1 - EXHIBIT 31.1 - IASIS Healthcare LLC | c92860exv31w1.htm |
| EX-10.18 - EXHIBIT 10.18 - IASIS Healthcare LLC | c92860exv10w18.htm |
| EX-10.14 - EXHIBIT 10.14 - IASIS Healthcare LLC | c92860exv10w14.htm |
Exhibit 10.16
|
ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM ADMINISTRATION DIVISION OF BUSINESS AND FINANCE SECTION A: CONTRACT |
1. AMENDMENT
|
2. CONTRACT | 3. EFFECTIVE DATE OF | 4. PROGRAM | |||
NUMBER:
|
NO.: | AMENDMENT: | ||||
7
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YH09-0001-04 | October 1, 2009 | DHCM — ACUTE |
5. CONTRACTOR’S NAME AND ADDRESS:
Health Choice Arizona
410 N. 44th Street, Suite 900
Phoenix, AZ 85008
410 N. 44th Street, Suite 900
Phoenix, AZ 85008
6. PURPOSE OF AMENDMENT: To amend Section B, Capitation Rates.
7. THE CONTRACT REFERENCED ABOVE FOLLOWS
A.
Section B contains revised Capitation Rates (see attached rate sheet).
NOTE: Please sign, date, and return executed file by E-Mail to:
|
Mark Held at Mark.Held@azahcccs.gov | |||
| Sr. Procurement Specialist | ||||
| AHCCCS Contracts and Purchasing | ||||
| and Georgina Maya at | ||||
| Georgina.Maya@azahcccs.gov |
8. EXCEPT AS PROVIDED FOR HEREIN, ALL TERMS AND CONDITIONS OF THE ORIGINAL CONTRACT NOT
HERETOFORE CHANGED AND/OR AMENDED REMAIN UNCHANGED AND IN FULL
EFFECT.
IN WITNESS WHEREOF THE PARTIES HERETO SIGN THEIR NAMES IN AGREEMENT
9. SIGNATURE OF AUTHORIZED
|
10. SIGNATURE OF AHCCCSA CONTRACTING | |
REPRESENTATIVE:
|
OFFICER: | |
| /s/ Carolyn Rose | /s/ Michael Veit | |
TYPED NAME: CAROLYN ROSE
|
TYPED NAME: MICHAEL VEIT | |
TITLE: CHIEF EXECUTIVE OFFICER
|
TITLE: CONTRACTS & PURCHASING ADMINISTRATOR | |
DATE: SEP 15 2009
|
DATE: SEP 10 2009 |
ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM
CAPITATION RATE SUMMARY — ACUTE RATES (Risk Adjusted-BRB
Health Choice Arizona
10/1/09-9/30/10
CAPITATION RATE SUMMARY — ACUTE RATES (Risk Adjusted-BRB
Health Choice Arizona
10/1/09-9/30/10
| Maternity | ||||||||||||||||||||||||||||||||||||||||||||
| TANF | TANF | TANF | TANF | TANF | SSI | SSI | Delivery | |||||||||||||||||||||||||||||||||||||
| Title XIX and KidsCare Rates 1: | <1, M/F | 1-13, M/F | 14-44, F | 14-44, M | 45+, M/F | w/ Med | w/o Med | SFP | Supplement | Non-MED | MED | |||||||||||||||||||||||||||||||||
2 Yuma/La Paz |
$ | 450.42 | $ | 100.40 | $ | 194.72 | $ | 118.73 | $ | 326.78 | $ | 162.35 | $ | 661.42 | $ | 18.93 | $ | 6,243.32 | $ | 423.36 | $ | 1,620.99 | ||||||||||||||||||||||
4 Apache/Coconino/Mohave/Navajo |
$ | 465.73 | $ | 116.91 | $ | 282.02 | $ | 160.40 | $ | 450.93 | $ | 171.73 | $ | 832.83 | $ | 17.31 | $ | 6,304.05 | $ | 541.96 | $ | 1,373.39 | ||||||||||||||||||||||
10 Pima/Santa Cruz |
$ | 419.94 | $ | 101.91 | $ | 232.65 | $ | 127.33 | $ | 394.85 | $ | 144.21 | $ | 742.80 | $ | 19.26 | $ | 6,607.00 | $ | 455.70 | $ | 1,298.57 | ||||||||||||||||||||||
12 Maricopa |
$ | 527.46 | $ | 111.73 | $ | 237.09 | $ | 141.50 | $ | 393.67 | $ | 138.84 | $ | 714.48 | $ | 17.15 | $ | 6,716.61 | $ | 554.96 | $ | 1,327.93 | ||||||||||||||||||||||
| TANF | TANF | TANF | TANF | TANF | SSI | SSI | ||||||||||||||||||||||||||||||
| PPC Rates: | <1, M/F | 1-13, M/F | 14-44, F | 14-44, M | 45+, M/F | w/ Med | w/o Med | Non-MED | MED | |||||||||||||||||||||||||||
2 Yuma/La Paz |
$ | 1,135.99 | $ | 66.84 | $ | 238.86 | $ | 206.91 | $ | 425.70 | $ | 150.25 | $ | 393.54 | $ | 1,049.84 | $ | 7,380.18 | ||||||||||||||||||
4 Apache/Coconino/Mohave/Navajo |
$ | 1,120.60 | $ | 65.01 | $ | 254.94 | $ | 214.09 | $ | 434.27 | $ | 151.34 | $ | 391.21 | $ | 1,034.48 | $ | 7,279.94 | ||||||||||||||||||
10 Pima/Santa Cruz |
$ | 1,098.32 | $ | 58.37 | $ | 240.31 | $ | 197.74 | $ | 425.71 | $ | 146.13 | $ | 392.20 | $ | 785.70 | $ | 7,207.00 | ||||||||||||||||||
12 Maricopa |
$ | 1,085.49 | $ | 69.06 | $ | 243.30 | $ | 212.06 | $ | 415.99 | $ | 142.15 | $ | 390.25 | $ | 1,196.57 | $ | 7,204.01 | ||||||||||||||||||
| Option 1 | Option 2 | |||||||
| Other Rates: | Transplant | Transplant | ||||||
2 Yuma/La Paz |
$ | 22.50 | $ | 22.50 | ||||
4 Apache/Coconino/Mohave/Navajo |
$ | 22.50 | $ | 22.50 | ||||
10 Pima/Santa Cruz |
$ | 22.50 | $ | 22.50 | ||||
12 Maricopa |
$ | 22.50 | $ | 22.50 | ||||
1.
Rates have been adjusted for $35,000 Reinsurance
Deductible