Exhibit 10.18

		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.:		CONTRACT:
9		YH09-0001-04		October 1, 2009		DHCM — ACUTE

5. CONTRACTOR’S NAME AND ADDRESS:

Health Choice Arizona
410 N. 44^th Street, Suite 900
Phoenix, AZ 85008

6. PURPOSE OF AMENDMENT: To amend Section D.

7. THE CONTRACT REFERENCED ABOVE FOLLOWS

A.

Section D, Paragraph 53, Compensation, Subparagraph 11 revised to the following language:

Reconciliation of Prospective non-MED Costs to Reimbursement: For CYE 09, AHCCCS will reconcile the Contractor’s prospective non-MED medical cost expenses to prospective non-MED net capitation paid to the Contractor for dates of service July 1, 2009 through September 30, 2009. This reconciliation will limit the Contractor’s profits and losses to 3%. Any losses in excess of 3% will be reimbursed to the Contractor, and likewise, profits in excess of 3% will be recouped. Adjudicated encounter data will be used to determine medical expenses. Refer to the Prospective non-MED Reconciliation Policy included in the ACOM for further details.

For CYE 10, AHCCCS will reconcile the Contractor’s prospective non-MED medical cost expenses to prospective non-MED net capitation paid to the Contractor for dates of service during the contract year being reconciled. This reconciliation will limit the Contractor’s profits and losses to 2%. Any losses in excess of 2% will be reimbursed to the Contractor, and likewise, profits in excess of 2% will be recouped. Adjudicated encounter data will be used to determine medical expenses. Refer to the Prospective non-MED Reconciliation Policy included in the ACOM for further details.

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 REPRESENTATIVE:		10. SIGNATURE OF AHCCCSA CONTRACTING OFFICER:
/s/ Carolyn Rose		/s/ Michael Veit
TYPED NAME: Carolyn Rose		TYPED NAME: MICHAEL VEIT
TITLE: Chief Executive Officer		TITLE: CONTRACTS & PURCHASING ADMINISTRATOR
DATE: Oct 07 2009		DATE: Oct 02 2009