Exhibit 10.1
HealthEase of Florida, Inc.
Medicaid HMO Contract
AHCA CONTRACT NO. FA619
AMENDMENT NO. 3
THIS CONTRACT, entered into between the STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, hereinafter referred to as the "Agency" and HEALTHEASE OF FLORIDA, INC., hereinafter referred to as the "Vendor" or “Health Plan”, is hereby amended as follows:
1. | Standard Contract, Section II, Item A, Contract Amount, the first sentence is hereby revised to now read as follows: |
To pay for contracted services according to the conditions of Attachment I in an amount not to exceed $1,098,394,977.00 (a decrease of $152,582,526.00), subject to availability of funds. |
2. | Attachment I, Section B, Method of Payment, Item 1, General, the first paragraph is hereby revised to now read as follows: |
Notwithstanding the payment amounts which may be computed with the rate tables specified in Exhibit III-C, the sum of total capitation payments under this Contract shall not exceed the total Contract amount of $1,098,394,977.00 (a decrease of $152,582,526.00). |
3. | Attachment I, Scope of Services, is hereby amended to include Exhibit III-C, January 1, 2008 – August 31, 2008 Medicaid Non-Reform HMO Capitation Rates, attached hereto and made a part of the Contract. All references in the Contract to Exhibit III-B, September 1, 2007 – August 31, 2008 Medicaid Non-Reform HMO Capitation Rates, shall hereinafter instead refer to Exhibit III-C, January 1, 2008 - August 31, 2008 Medicaid Non-Reform HMO Capitation Rates. |
4. | This Amendment shall have an effective date of January 1, 2008, or the date on which both parties execute the Amendment, whichever is later. |
All provisions in the Contract and any attachments thereto in conflict with this Amendment shall be and are hereby changed to conform with this Amendment.
All provisions not in conflict with this Amendment are still in effect and are to be performed at the level specified in the Contract.
This Amendment and all its attachments are hereby made a part of the Contract.
This Amendment cannot be executed unless all previous amendments to this Contract have been fully executed.
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
AHCA Contract No. FA619, Amendment No. 3, Page 1 of 2
IN WITNESS WHEREOF, the parties hereto have caused this seven (7) page Amendment (which includes all attachments hereto) to be executed by their officials thereunto duly authorized.
HEALTHEASE OF FLORIDA, INC. | STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION |
SIGNED BY: /s/ Todd S. Farha | SIGNED BY: /s/ Illegible |
NAME: Todd S. Farha | (for) NAME: Andrew C. Agwunobi, M.D. |
TITLE: President and CEO | TITLE: Secretary |
DATE:1/2/08 | DATE: 1/3/08 |
List of attachments included as part of this Amendment:
Specify Type | Letter/ Number | Description |
Exhibit | III-C | January 1, 2008 - August 31, 2008 Medicaid Non-Reform HMO Capitation Rates (5 Pages) |
AHCA Contract No. FA619, Amendment No. 3, Page 2 of 2
EXHIBIT III-C | |||||||||||||||||||
January 1, 2008 - August 31, 2008 | |||||||||||||||||||
MEDICAID Non-Reform HMO CAPITATION RATES | |||||||||||||||||||
By Area , Age and Eligibility Category | |||||||||||||||||||
TABLE 1 | |||||||||||||||||||
General Rates: | |||||||||||||||||||
TANF | SSI-N | SSI-B | SSI-AB | ||||||||||||||||
Area | BTHMO +2MO | 3MO-11MO | AGE (1-5) | AGE (6-13) | AGE (14-20) | AGE (21-54) | AGE (55+) | BTHMO +2MO | 3MO-11MO | AGE (1-5) | AGE (6-13) | AGE (14-20) | AGE (21-54) | AGE (55+) | AGE (65-) | AGE (65+) | |||
Female | Male | Female | Male | ||||||||||||||||
01 | 1,113.27 | 198.95 | 103.84 | 65.12 | 132.96 | 71.10 | 261.06 | 165.11 | 341.74 | 9,915.13 | 1,434.75 | 428.74 | 197.94 | 218.40 | 704.25 | 692.24 | 266.36 | 96.67 | 79.38 |
02 | 1,113.27 | 198.95 | 103.84 | 65.12 | 132.96 | 71.10 | 261.06 | 165.11 | 341.74 | 9,915.13 | 1,434.75 | 428.74 | 197.94 | 218.40 | 704.25 | 692.24 | 266.36 | 96.67 | 79.38 |
03 | 1,274.97 | 229.73 | 120.11 | 76.19 | 153.87 | 83.11 | 303.58 | 192.99 | 401.92 | 11,138.97 | 1,629.39 | 486.94 | 229.48 | 252.31 | 812.92 | 803.12 | 268.11 | 89.89 | 74.16 |
04 | 1,110.20 | 200.37 | 105.01 | 66.79 | 134.42 | 72.81 | 265.41 | 168.95 | 352.65 | 10,499.42 | 1,537.71 | 460.11 | 217.21 | 238.35 | 768.93 | 759.32 | 324.10 | 92.63 | 76.37 |
05 | 1,239.65 | 223.90 | 117.11 | 74.70 | 150.07 | 81.25 | 296.43 | 188.63 | 393.68 | 11,579.76 | 1,692.54 | 506.42 | 237.96 | 262.13 | 843.24 | 832.21 | 224.84 | 86.91 | 72.45 |
06 | 1,093.25 | 198.54 | 104.28 | 66.96 | 133.36 | 72.80 | 264.61 | 168.97 | 354.37 | 10,652.91 | 1,564.02 | 468.08 | 222.16 | 243.74 | 785.88 | 776.94 | 278.82 | 84.03 | 69.54 |
07 | 1,111.11 | 201.05 | 105.33 | 67.26 | 134.84 | 73.19 | 266.60 | 169.92 | 355.07 | 10,979.12 | 1,613.56 | 482.68 | 229.82 | 251.86 | 810.88 | 802.37 | 320.94 | 87.44 | 72.54 |
08 | 1,042.42 | 189.18 | 99.15 | 63.67 | 127.01 | 69.25 | 251.65 | 160.56 | 336.69 | 9,334.29 | 1,365.81 | 408.73 | 192.99 | 211.83 | 682.67 | 674.08 | 187.79 | 83.02 | 68.67 |
09 | 1,080.64 | 194.68 | 101.92 | 64.82 | 130.37 | 70.43 | 257.53 | 163.82 | 341.26 | 10,421.98 | 1,530.82 | 457.89 | 217.75 | 238.53 | 769.06 | 760.32 | 201.31 | 90.28 | 74.77 |
10 | 1,100.94 | 199.64 | 104.76 | 67.19 | 133.94 | 73.01 | 265.61 | 169.34 | 354.88 | 13,515.72 | 1,994.98 | 596.62 | 285.93 | 313.86 | 1,009.79 | 999.91 | 251.29 | 103.32 | 85.55 |
11 | 1,424.99 | 256.12 | 134.00 | 84.75 | 171.50 | 92.47 | 338.04 | 214.66 | 446.26 | 14,158.43 | 2,076.63 | 621.17 | 294.21 | 323.57 | 1,040.93 | 1,029.21 | 329.75 | 157.24 | 128.37 |
TABLE 2 | |||||||||||||||||||
General + Mental Health Rates: | |||||||||||||||||||
TANF | SSI-N | SSI-B | SSI-AB | ||||||||||||||||
Area | BTHMO +2MO | 3MO-11MO | AGE (1-5) | AGE (6-13) | AGE (14-20) | AGE (21-54) | AGE (55+) | BTHMO +2MO | 3MO-11MO | AGE (1-5) | AGE (6-13) | AGE (14-20) | AGE (21-54) | AGE (55+) | AGE (65-) | AGE (65+) | |||
Female | Male | Female | Male | ||||||||||||||||
01 | 1,113.29 | 198.97 | 105.45 | 76.61 | 143.70 | 81.84 | 265.43 | 169.48 | 345.42 | 9,915.21 | 1,434.83 | 436.06 | 245.19 | 261.65 | 784.29 | 722.71 | 266.57 | 108.13 | 90.84 |
02 | 1,113.30 | 198.98 | 106.70 | 85.04 | 146.15 | 84.29 | 264.41 | 168.46 | 344.65 | 9,915.29 | 1,434.91 | 442.30 | 275.44 | 262.86 | 756.05 | 716.70 | 286.23 | 111.42 | 94.13 |
03 | 1,274.98 | 229.74 | 121.41 | 85.22 | 159.85 | 89.09 | 305.10 | 194.51 | 403.24 | 11,139.04 | 1,629.46 | 493.10 | 264.64 | 272.48 | 836.42 | 814.21 | 274.85 | 98.72 | 82.99 |
04 | 1,110.21 | 200.38 | 106.36 | 76.19 | 140.65 | 79.04 | 266.99 | 170.53 | 354.02 | 10,499.53 | 1,537.82 | 469.70 | 272.02 | 269.79 | 805.57 | 776.62 | 348.24 | 109.12 | 92.86 |
05 | 1,239.66 | 223.91 | 118.30 | 83.23 | 158.04 | 89.22 | 299.67 | 191.87 | 396.42 | 11,579.81 | 1,692.59 | 511.36 | 269.84 | 291.31 | 897.24 | 852.76 | 227.52 | 99.51 | 85.05 |
06 | 1,093.27 | 198.56 | 106.10 | 79.99 | 145.53 | 84.97 | 269.56 | 173.92 | 358.55 | 10,652.98 | 1,564.09 | 474.49 | 263.57 | 281.64 | 856.02 | 803.63 | 280.11 | 87.85 | 73.36 |
07 | 1,111.13 | 201.07 | 107.08 | 79.74 | 146.50 | 84.85 | 271.34 | 174.66 | 359.07 | 10,979.18 | 1,613.62 | 488.70 | 268.67 | 287.42 | 876.69 | 827.42 | 323.49 | 97.78 | 82.88 |
08 | 1,042.43 | 189.19 | 100.39 | 72.32 | 132.74 | 74.98 | 253.11 | 162.02 | 337.95 | 9,334.36 | 1,365.88 | 414.63 | 226.70 | 231.18 | 705.20 | 684.72 | 194.53 | 96.02 | 81.67 |
09 | 1,080.66 | 194.70 | 103.44 | 75.45 | 137.41 | 77.47 | 259.32 | 165.61 | 342.81 | 10,422.05 | 1,530.89 | 464.12 | 253.29 | 258.93 | 792.81 | 771.54 | 208.05 | 99.71 | 84.20 |
10 | 1,100.96 | 199.66 | 106.65 | 80.33 | 142.64 | 81.71 | 267.82 | 171.55 | 356.80 | 13,515.81 | 1,995.07 | 604.83 | 332.84 | 340.78 | 1,041.14 | 1,014.71 | 258.03 | 111.24 | 93.47 |
11 | 1,425.01 | 256.14 | 135.59 | 95.85 | 178.86 | 99.83 | 339.91 | 216.53 | 447.88 | 14,158.51 | 2,076.71 | 628.03 | 333.34 | 346.02 | 1,067.09 | 1,041.56 | 336.86 | 165.16 | 136.29 |
AHCA Contract No. FA619, Exhibit III-C, Page 1 of 5
EXHIBIT III-C | |||||||||||||||||||
January 1, 2008 - August 31, 2008 | |||||||||||||||||||
MEDICAID Non-Reform HMO CAPITATION RATES | |||||||||||||||||||
By Area , Age and Eligibility Category |
TABLE 3 | |||||||||||||||||||
General + MH + Dental Rates: | |||||||||||||||||||
TANF | SSI-N | SSI-B | SSI-AB | ||||||||||||||||
Area | BTHMO +2MO | 3MO-11MO | AGE (1-5) | AGE (6-13) | AGE (14-20) | AGE (21-54) | AGE (55+) | BTHMO +2MO | 3MO-11MO | AGE (1-5) | AGE (6-13) | AGE (14-20) | AGE (21-54) | AGE (55+) | AGE (65-) | AGE (65+) | |||
Female | Male | Female | Male | ||||||||||||||||
01 | 1,113.30 | 198.98 | 107.51 | 80.86 | 148.10 | 85.55 | 267.24 | 171.09 | 348.77 | 9,915.21 | 1,434.84 | 438.23 | 248.95 | 264.93 | 787.11 | 726.07 | 267.06 | 110.40 | 92.29 |
02 | 1,113.31 | 198.99 | 108.76 | 89.29 | 150.55 | 88.00 | 266.22 | 170.07 | 348.00 | 9,915.29 | 1,434.92 | 444.47 | 279.20 | 266.14 | 758.87 | 720.06 | 286.72 | 113.69 | 95.58 |
03 | 1,274.99 | 229.75 | 124.44 | 91.46 | 166.32 | 94.55 | 308.06 | 197.14 | 408.70 | 11,139.05 | 1,629.48 | 496.42 | 270.39 | 277.50 | 839.92 | 818.38 | 275.38 | 101.75 | 84.93 |
04 | 1,110.22 | 200.39 | 108.37 | 80.34 | 144.96 | 82.68 | 269.75 | 172.98 | 359.12 | 10,499.53 | 1,537.83 | 471.87 | 275.78 | 273.08 | 808.82 | 780.50 | 350.21 | 112.15 | 94.80 |
05 | 1,239.67 | 223.93 | 121.70 | 90.26 | 165.34 | 95.37 | 306.75 | 198.16 | 409.49 | 11,579.82 | 1,692.61 | 516.20 | 278.22 | 298.64 | 904.66 | 861.60 | 231.88 | 107.72 | 90.31 |
06 | 1,093.28 | 198.57 | 108.70 | 85.35 | 151.09 | 89.66 | 273.12 | 177.08 | 365.12 | 10,652.98 | 1,564.10 | 477.61 | 268.98 | 286.37 | 860.37 | 808.82 | 281.92 | 92.55 | 76.38 |
07 | 1,111.14 | 201.08 | 109.20 | 84.12 | 151.04 | 88.68 | 273.83 | 176.87 | 363.67 | 10,979.18 | 1,613.63 | 491.76 | 273.97 | 292.05 | 879.75 | 831.07 | 325.09 | 100.89 | 84.88 |
08 | 1,042.44 | 189.20 | 103.37 | 78.47 | 139.11 | 80.35 | 256.08 | 164.65 | 343.42 | 9,334.36 | 1,365.89 | 417.70 | 232.02 | 235.83 | 708.74 | 688.94 | 195.98 | 99.12 | 83.66 |
09 | 1,080.67 | 194.71 | 106.32 | 81.39 | 143.57 | 82.66 | 261.04 | 167.14 | 345.98 | 10,422.05 | 1,530.90 | 466.81 | 257.94 | 263.00 | 794.47 | 773.52 | 208.76 | 101.52 | 85.36 |
10 | 1,100.97 | 199.67 | 109.45 | 86.12 | 148.64 | 86.77 | 269.62 | 173.15 | 360.11 | 13,515.82 | 1,995.09 | 608.51 | 339.22 | 346.35 | 1,043.21 | 1,017.18 | 260.05 | 113.76 | 95.09 |
11 | 1,425.02 | 256.15 | 139.31 | 103.51 | 186.81 | 106.53 | 341.50 | 217.94 | 450.82 | 14,158.52 | 2,076.73 | 632.27 | 340.68 | 352.44 | 1,070.67 | 1,045.82 | 341.18 | 169.15 | 138.85 |
TABLE 4 | |||||||||||||||||||
General + MH + Transportation Rates: | |||||||||||||||||||
TANF | SSI-N | SSI-B | SSI-AB | ||||||||||||||||
Area | BTHMO +2MO | 3MO-11MO | AGE (1-5) | AGE (6-13) | AGE (14-20) | AGE (21-54) | AGE (55+) | BTHMO +2MO | 3MO-11MO | AGE (1-5) | AGE (6-13) | AGE (14-20) | AGE (21-54) | AGE (55+) | AGE (65-) | AGE (65+) | |||
Female | Male | Female | Male | ||||||||||||||||
01 | 1,118.75 | 200.33 | 106.30 | 77.12 | 145.59 | 83.08 | 268.47 | 171.82 | 348.55 | 9,957.91 | 1,462.40 | 441.61 | 247.63 | 267.67 | 803.95 | 738.94 | 273.23 | 121.63 | 99.45 |
02 | 1,118.76 | 200.34 | 107.55 | 85.55 | 148.04 | 85.53 | 267.45 | 170.80 | 347.78 | 9,957.99 | 1,462.48 | 447.85 | 277.88 | 268.88 | 775.71 | 732.93 | 292.89 | 124.92 | 102.74 |
03 | 1,281.58 | 231.39 | 122.43 | 85.84 | 162.13 | 90.58 | 308.77 | 197.34 | 407.02 | 11,192.94 | 1,664.26 | 500.10 | 267.71 | 280.08 | 861.25 | 834.72 | 283.33 | 118.23 | 95.44 |
04 | 1,115.15 | 201.61 | 107.13 | 76.65 | 142.36 | 80.16 | 269.73 | 172.65 | 356.86 | 10,543.16 | 1,565.99 | 475.37 | 274.51 | 275.95 | 825.67 | 793.21 | 355.09 | 124.64 | 102.76 |
05 | 1,243.79 | 224.94 | 118.94 | 83.62 | 159.46 | 90.15 | 301.97 | 193.65 | 398.78 | 11,614.53 | 1,714.99 | 515.87 | 271.82 | 296.21 | 913.23 | 865.96 | 233.30 | 113.31 | 93.85 |
06 | 1,097.25 | 199.55 | 106.72 | 80.36 | 146.91 | 85.87 | 271.77 | 175.63 | 360.83 | 10,687.23 | 1,586.20 | 478.95 | 265.53 | 286.48 | 871.79 | 816.65 | 285.34 | 99.27 | 80.64 |
07 | 1,115.00 | 202.04 | 107.68 | 80.11 | 147.83 | 85.72 | 273.49 | 176.32 | 361.29 | 11,015.88 | 1,637.32 | 493.47 | 270.76 | 292.60 | 893.60 | 841.37 | 329.04 | 109.71 | 90.50 |
08 | 1,047.92 | 190.56 | 101.24 | 72.83 | 134.64 | 76.22 | 256.16 | 164.37 | 341.09 | 9,375.02 | 1,392.12 | 419.92 | 229.03 | 236.92 | 723.92 | 700.18 | 200.51 | 110.58 | 90.96 |
09 | 1,085.95 | 196.02 | 104.26 | 75.95 | 139.24 | 78.67 | 262.26 | 167.88 | 345.85 | 10,464.52 | 1,558.31 | 469.65 | 255.72 | 264.93 | 812.36 | 787.69 | 214.85 | 115.26 | 94.12 |
10 | 1,104.68 | 200.59 | 107.22 | 80.68 | 143.93 | 82.55 | 269.89 | 173.15 | 358.93 | 13,554.29 | 2,019.92 | 609.83 | 335.04 | 346.22 | 1,058.87 | 1,029.34 | 265.22 | 128.61 | 104.55 |
11 | 1,428.21 | 256.94 | 136.08 | 96.15 | 179.96 | 100.55 | 341.69 | 217.91 | 449.71 | 14,187.41 | 2,095.37 | 631.78 | 334.99 | 350.10 | 1,080.40 | 1,052.54 | 341.70 | 177.46 | 144.14 |
AHCA Contract No. FA619, Exhibit III-C, Page 2 of 5
EXHIBIT III-C | |||||||||||||||||||
January 1, 2008 - August 31, 2008 | |||||||||||||||||||
MEDICAID Non-Reform HMO CAPITATION RATES | |||||||||||||||||||
By Area , Age and Eligibility Category |
TABLE 5 | |||||||||||||||||||
General + Transportation Rates: | |||||||||||||||||||
TANF | SSI-N | SSI-B | SSI-AB | ||||||||||||||||
Area | BTHMO +2MO | 3MO-11MO | AGE (1-5) | AGE (6-13) | AGE (14-20) | AGE (21-54) | AGE (55+) | BTHMO +2MO | 3MO-11MO | AGE (1-5) | AGE (6-13) | AGE (14-20) | AGE (21-54) | AGE (55+) | AGE (65-) | AGE (65+) | |||
Female | Male | Female | Male | ||||||||||||||||
01 | 1,118.73 | 200.31 | 104.69 | 65.63 | 134.85 | 72.34 | 264.10 | 167.45 | 344.87 | 9,957.83 | 1,462.32 | 434.29 | 200.38 | 224.42 | 723.91 | 708.47 | 273.02 | 110.17 | 87.99 |
02 | 1,118.73 | 200.31 | 104.69 | 65.63 | 134.85 | 72.34 | 264.10 | 167.45 | 344.87 | 9,957.83 | 1,462.32 | 434.29 | 200.38 | 224.42 | 723.91 | 708.47 | 273.02 | 110.17 | 87.99 |
03 | 1,281.57 | 231.38 | 121.13 | 76.81 | 156.15 | 84.60 | 307.25 | 195.82 | 405.70 | 11,192.87 | 1,664.19 | 493.94 | 232.55 | 259.91 | 837.75 | 823.63 | 276.59 | 109.40 | 86.61 |
04 | 1,115.14 | 201.60 | 105.78 | 67.25 | 136.13 | 73.93 | 268.15 | 171.07 | 355.49 | 10,543.05 | 1,565.88 | 465.78 | 219.70 | 244.51 | 789.03 | 775.91 | 330.95 | 108.15 | 86.27 |
05 | 1,243.78 | 224.93 | 117.75 | 75.09 | 151.49 | 82.18 | 298.73 | 190.41 | 396.04 | 11,614.48 | 1,714.94 | 510.93 | 239.94 | 267.03 | 859.23 | 845.41 | 230.62 | 100.71 | 81.25 |
06 | 1,097.23 | 199.53 | 104.90 | 67.33 | 134.74 | 73.70 | 266.82 | 170.68 | 356.65 | 10,687.16 | 1,586.13 | 472.54 | 224.12 | 248.58 | 801.65 | 789.96 | 284.05 | 95.45 | 76.82 |
07 | 1,114.98 | 202.02 | 105.93 | 67.63 | 136.17 | 74.06 | 268.75 | 171.58 | 357.29 | 11,015.82 | 1,637.26 | 487.45 | 231.91 | 257.04 | 827.79 | 816.32 | 326.49 | 99.37 | 80.16 |
08 | 1,047.91 | 190.55 | 100.00 | 64.18 | 128.91 | 70.49 | 254.70 | 162.91 | 339.83 | 9,374.95 | 1,392.05 | 414.02 | 195.32 | 217.57 | 701.39 | 689.54 | 193.77 | 97.58 | 77.96 |
09 | 1,085.93 | 196.00 | 102.74 | 65.32 | 132.20 | 71.63 | 260.47 | 166.09 | 344.30 | 10,464.45 | 1,558.24 | 463.42 | 220.18 | 244.53 | 788.61 | 776.47 | 208.11 | 105.83 | 84.69 |
10 | 1,104.66 | 200.57 | 105.33 | 67.54 | 135.23 | 73.85 | 267.68 | 170.94 | 357.01 | 13,554.20 | 2,019.83 | 601.62 | 288.13 | 319.30 | 1,027.52 | 1,014.54 | 258.48 | 120.69 | 96.63 |
11 | 1,428.19 | 256.92 | 134.49 | 85.05 | 172.60 | 93.19 | 339.82 | 216.04 | 448.09 | 14,187.33 | 2,095.29 | 624.92 | 295.86 | 327.65 | 1,054.24 | 1,040.19 | 334.59 | 169.54 | 136.22 |
TABLE 6 | |||||||||||||||||||
General + Dental Rates: | |||||||||||||||||||
TANF | SSI-N | SSI-B | SSI-AB | ||||||||||||||||
Area | BTHMO +2MO | 3MO-11MO | AGE (1-5) | AGE (6-13) | AGE (14-20) | AGE (21-54) | AGE (55+) | BTHMO +2MO | 3MO-11MO | AGE (1-5) | AGE (6-13) | AGE (14-20) | AGE (21-54) | AGE (55+) | AGE (65-) | AGE (65+) | |||
Female | Male | Female | Male | ||||||||||||||||
01 | 1,113.28 | 198.96 | 105.90 | 69.37 | 137.36 | 74.81 | 262.87 | 166.72 | 345.09 | 9,915.13 | 1,434.76 | 430.91 | 201.70 | 221.68 | 707.07 | 695.60 | 266.85 | 98.94 | 80.83 |
02 | 1,113.28 | 198.96 | 105.90 | 69.37 | 137.36 | 74.81 | 262.87 | 166.72 | 345.09 | 9,915.13 | 1,434.76 | 430.91 | 201.70 | 221.68 | 707.07 | 695.60 | 266.85 | 98.94 | 80.83 |
03 | 1,274.98 | 229.74 | 123.14 | 82.43 | 160.34 | 88.57 | 306.54 | 195.62 | 407.38 | 11,138.98 | 1,629.41 | 490.26 | 235.23 | 257.33 | 816.42 | 807.29 | 268.64 | 92.92 | 76.10 |
04 | 1,110.21 | 200.38 | 107.02 | 70.94 | 138.73 | 76.45 | 268.17 | 171.40 | 357.75 | 10,499.42 | 1,537.72 | 462.28 | 220.97 | 241.64 | 772.18 | 763.20 | 326.07 | 95.66 | 78.31 |
05 | 1,239.66 | 223.92 | 120.51 | 81.73 | 157.37 | 87.40 | 303.51 | 194.92 | 406.75 | 11,579.77 | 1,692.56 | 511.26 | 246.34 | 269.46 | 850.66 | 841.05 | 229.20 | 95.12 | 77.71 |
06 | 1,093.26 | 198.55 | 106.88 | 72.32 | 138.92 | 77.49 | 268.17 | 172.13 | 360.94 | 10,652.91 | 1,564.03 | 471.20 | 227.57 | 248.47 | 790.23 | 782.13 | 280.63 | 88.73 | 72.56 |
07 | 1,111.12 | 201.06 | 107.45 | 71.64 | 139.38 | 77.02 | 269.09 | 172.13 | 359.67 | 10,979.12 | 1,613.57 | 485.74 | 235.12 | 256.49 | 813.94 | 806.02 | 322.54 | 90.55 | 74.54 |
08 | 1,042.43 | 189.19 | 102.13 | 69.82 | 133.38 | 74.62 | 254.62 | 163.19 | 342.16 | 9,334.29 | 1,365.82 | 411.80 | 198.31 | 216.48 | 686.21 | 678.30 | 189.24 | 86.12 | 70.66 |
09 | 1,080.65 | 194.69 | 104.80 | 70.76 | 136.53 | 75.62 | 259.25 | 165.35 | 344.43 | 10,421.98 | 1,530.83 | 460.58 | 222.40 | 242.60 | 770.72 | 762.30 | 202.02 | 92.09 | 75.93 |
10 | 1,100.95 | 199.65 | 107.56 | 72.98 | 139.94 | 78.07 | 267.41 | 170.94 | 358.19 | 13,515.73 | 1,995.00 | 600.30 | 292.31 | 319.43 | 1,011.86 | 1,002.38 | 253.31 | 105.84 | 87.17 |
11 | 1,425.00 | 256.13 | 137.72 | 92.41 | 179.45 | 99.17 | 339.63 | 216.07 | 449.20 | 14,158.44 | 2,076.65 | 625.41 | 301.55 | 329.99 | 1,044.51 | 1,033.47 | 334.07 | 161.23 | 130.93 |
AHCA Contract No. FA619, Exhibit III-C, Page 3 of 5
EXHIBIT III-C | |||||||||||||||||||
January 1, 2008 - August 31, 2008 | |||||||||||||||||||
MEDICAID Non-Reform HMO CAPITATION RATES | |||||||||||||||||||
By Area , Age and Eligibility Category |
TABLE 7 | |||||||||||||||||||
General + Dental + Transportation Rates: | |||||||||||||||||||
TANF | SSI-N | SSI-B | SSI-AB | ||||||||||||||||
Area | BTHMO +2MO | 3MO-11MO | AGE (1-5) | AGE (6-13) | AGE (14-20) | AGE (21-54) | AGE (55+) | BTHMO +2MO | 3MO-11MO | AGE (1-5) | AGE (6-13) | AGE (14-20) | AGE (21-54) | AGE (55+) | AGE (65-) | AGE (65+) | |||
Female | Male | Female | Male | ||||||||||||||||
01 | 1,118.74 | 200.32 | 106.75 | 69.88 | 139.25 | 76.05 | 265.91 | 169.06 | 348.22 | 9,957.83 | 1,462.33 | 436.46 | 204.14 | 227.70 | 726.73 | 711.83 | 273.51 | 112.44 | 89.44 |
02 | 1,118.74 | 200.32 | 106.75 | 69.88 | 139.25 | 76.05 | 265.91 | 169.06 | 348.22 | 9,957.83 | 1,462.33 | 436.46 | 204.14 | 227.70 | 726.73 | 711.83 | 273.51 | 112.44 | 89.44 |
03 | 1,281.58 | 231.39 | 124.16 | 83.05 | 162.62 | 90.06 | 310.21 | 198.45 | 411.16 | 11,192.88 | 1,664.21 | 497.26 | 238.30 | 264.93 | 841.25 | 827.80 | 277.12 | 112.43 | 88.55 |
04 | 1,115.15 | 201.61 | 107.79 | 71.40 | 140.44 | 77.57 | 270.91 | 173.52 | 360.59 | 10,543.05 | 1,565.89 | 467.95 | 223.46 | 247.80 | 792.28 | 779.79 | 332.92 | 111.18 | 88.21 |
05 | 1,243.79 | 224.95 | 121.15 | 82.12 | 158.79 | 88.33 | 305.81 | 196.70 | 409.11 | 11,614.49 | 1,714.96 | 515.77 | 248.32 | 274.36 | 866.65 | 854.25 | 234.98 | 108.92 | 86.51 |
06 | 1,097.24 | 199.54 | 107.50 | 72.69 | 140.30 | 78.39 | 270.38 | 173.84 | 363.22 | 10,687.16 | 1,586.14 | 475.66 | 229.53 | 253.31 | 806.00 | 795.15 | 285.86 | 100.15 | 79.84 |
07 | 1,114.99 | 202.03 | 108.05 | 72.01 | 140.71 | 77.89 | 271.24 | 173.79 | 361.89 | 11,015.82 | 1,637.27 | 490.51 | 237.21 | 261.67 | 830.85 | 819.97 | 328.09 | 102.48 | 82.16 |
08 | 1,047.92 | 190.56 | 102.98 | 70.33 | 135.28 | 75.86 | 257.67 | 165.54 | 345.30 | 9,374.95 | 1,392.06 | 417.09 | 200.64 | 222.22 | 704.93 | 693.76 | 195.22 | 100.68 | 79.95 |
09 | 1,085.94 | 196.01 | 105.62 | 71.26 | 138.36 | 76.82 | 262.19 | 167.62 | 347.47 | 10,464.45 | 1,558.25 | 466.11 | 224.83 | 248.60 | 790.27 | 778.45 | 208.82 | 107.64 | 85.85 |
10 | 1,104.67 | 200.58 | 108.13 | 73.33 | 141.23 | 78.91 | 269.48 | 172.54 | 360.32 | 13,554.21 | 2,019.85 | 605.30 | 294.51 | 324.87 | 1,029.59 | 1,017.01 | 260.50 | 123.21 | 98.25 |
11 | 1,428.20 | 256.93 | 138.21 | 92.71 | 180.55 | 99.89 | 341.41 | 217.45 | 451.03 | 14,187.34 | 2,095.31 | 629.16 | 303.20 | 334.07 | 1,057.82 | 1,044.45 | 338.91 | 173.53 | 138.78 |
TABLE 8 | |||||||||||||||||||
General + Mental Health + Dental + Transportation Rates: | |||||||||||||||||||
TANF | SSI-N | SSI-B | SSI-AB | ||||||||||||||||
Area | BTHMO +2MO | 3MO-11MO | AGE (1-5) | AGE (6-13) | AGE (14-20) | AGE (21-54) | AGE (55+) | BTHMO +2MO | 3MO-11MO | AGE (1-5) | AGE (6-13) | AGE (14-20) | AGE (21-54) | AGE (55+) | AGE (65-) | AGE (65+) | |||
Female | Male | Female | Male | ||||||||||||||||
01 | 1,118.76 | 200.34 | 108.36 | 81.37 | 149.99 | 86.79 | 270.28 | 173.43 | 351.90 | 9,957.91 | 1,462.41 | 443.78 | 251.39 | 270.95 | 806.77 | 742.30 | 273.72 | 123.90 | 100.90 |
02 | 1,118.77 | 200.35 | 109.61 | 89.80 | 152.44 | 89.24 | 269.26 | 172.41 | 351.13 | 9,957.99 | 1,462.49 | 450.02 | 281.64 | 272.16 | 778.53 | 736.29 | 293.38 | 127.19 | 104.19 |
03 | 1,281.59 | 231.40 | 125.46 | 92.08 | 168.60 | 96.04 | 311.73 | 199.97 | 412.48 | 11,192.95 | 1,664.28 | 503.42 | 273.46 | 285.10 | 864.75 | 838.89 | 283.86 | 121.26 | 97.38 |
04 | 1,115.16 | 201.62 | 109.14 | 80.80 | 146.67 | 83.80 | 272.49 | 175.10 | 361.96 | 10,543.16 | 1,566.00 | 477.54 | 278.27 | 279.24 | 828.92 | 797.09 | 357.06 | 127.67 | 104.70 |
05 | 1,243.80 | 224.96 | 122.34 | 90.65 | 166.76 | 96.30 | 309.05 | 199.94 | 411.85 | 11,614.54 | 1,715.01 | 520.71 | 280.20 | 303.54 | 920.65 | 874.80 | 237.66 | 121.52 | 99.11 |
06 | 1,097.26 | 199.56 | 109.32 | 85.72 | 152.47 | 90.56 | 275.33 | 178.79 | 367.40 | 10,687.23 | 1,586.21 | 482.07 | 270.94 | 291.21 | 876.14 | 821.84 | 287.15 | 103.97 | 83.66 |
07 | 1,115.01 | 202.05 | 109.80 | 84.49 | 152.37 | 89.55 | 275.98 | 178.53 | 365.89 | 11,015.88 | 1,637.33 | 496.53 | 276.06 | 297.23 | 896.66 | 845.02 | 330.64 | 112.82 | 92.50 |
08 | 1,047.93 | 190.57 | 104.22 | 78.98 | 141.01 | 81.59 | 259.13 | 167.00 | 346.56 | 9,375.02 | 1,392.13 | 422.99 | 234.35 | 241.57 | 727.46 | 704.40 | 201.96 | 113.68 | 92.95 |
09 | 1,085.96 | 196.03 | 107.14 | 81.89 | 145.40 | 83.86 | 263.98 | 169.41 | 349.02 | 10,464.52 | 1,558.32 | 472.34 | 260.37 | 269.00 | 814.02 | 789.67 | 215.56 | 117.07 | 95.28 |
10 | 1,104.69 | 200.60 | 110.02 | 86.47 | 149.93 | 87.61 | 271.69 | 174.75 | 362.24 | 13,554.30 | 2,019.94 | 613.51 | 341.42 | 351.79 | 1,060.94 | 1,031.81 | 267.24 | 131.13 | 106.17 |
11 | 1,428.22 | 256.95 | 139.80 | 103.81 | 187.91 | 107.25 | 343.28 | 219.32 | 452.65 | 14,187.42 | 2,095.39 | 636.02 | 342.33 | 356.52 | 1,083.98 | 1,056.80 | 346.02 | 181.45 | 146.70 |
AHCA Contract No. FA619, Exhibit III-C, Page 4 of 5
EXHIBIT III-C | |||||||||||||||||||
January 1, 2008 - August 31, 2008 | |||||||||||||||||||
MEDICAID Non-Reform HMO CAPITATION RATES | |||||||||||||||||||
By Area , Age and Eligibility Category |
Area | Corresponding Counties | ||||||||||||||||||
Area 1 | Escambia, Okaloosa, Santa Rosa, Walton | ||||||||||||||||||
Area 2 | Bay, Calhoun, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Taylor, Washington, Wakulla | ||||||||||||||||||
Area 3 | Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamiliton, Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee, Union | ||||||||||||||||||
Area 4 | Baker, Clay, Duval, Flagler, Nassau, St. Johns, Volusia | ||||||||||||||||||
Area 5 | Pasco, Pinellas | ||||||||||||||||||
Area 6 | Hardee, Highlands, Hillsborough, Manatee, Polk | ||||||||||||||||||
Area 7 | Brevard, Orange, Osceola, Seminole | ||||||||||||||||||
Area 8 | Charlotte, Collier, De Soto, Glades, Hendry, Lee, Sarasota | ||||||||||||||||||
Area 9 | Indian River, Okeechobee, St. Lucie, Martin, Palm Beach | ||||||||||||||||||
Area 10 | Broward | ||||||||||||||||||
Area 11 | Dade, Monroe | ||||||||||||||||||
created on August 19, 2006 | |||||||||||||||||||
modified on September 11, 2006 - incresing dental rates. |
AHCA Contract No. FA619, Exhibit III-C, Page 5 of 5