Exhibit 10.10
HEALTHEASE OF FLORIDA, INC., d/b/a HEALTHEASE MEDICAID HMO CONTRACT
AHCA CONTRACT NO. FA305
AMENDMENT NO. 010
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., d/b/a HealthEase, hereinafter referred to as the
"Vendor", is hereby amended as follows:
1. Attachment I, Section 90.0, Payment and Authorized Enrollment Levels, Table 1
is amended as shown below.
TABLE 1 PROJECTED ENROLLMENT
COUNTY Maximum Enrollment Level
ALACHUA 0
BAKER 0
BAY 0
BRADFORD 0
BREVARD 14,000
BROWARD 13,500
CALHOUN 500
CHARLOTTE 0
CITRUS 4,500
CLAY 3,200
COLLIER 0
COLUMBIA 0
DADE 20,000
DESOTO 0
DIXIE 0
DUVAL 40,000
ESCAMBIA 18,000
FRANKLIN 250
GADSDEN 3,500
GILCHRIST 0
GULF 0
HARDEE 0
HERNANDO 0
HIGHLANDS 3,000
HILLSBOROUGH 18,000
HOLMES 0
JEFFERSON 1,000
LAKE 6,000
LEE 0
LEON 6,000
LEVY 0
LIBERTY 400
MADISON 1,000
MANATEE 5,000
MARION 12,000
MARTIN 4,000
NASSAU 0
OKALOOSA 0
OKEECHOBEE 0
ORANGE 20,000
AHCA CONTRACT NO. FA305, AMENDMENT NO. 010, PAGE 1 OF 2
HEALTHEASE OF FLORIDA, INC., d/b/a HEALTHEASE MEDICAID HMO CONTRACT
OSCEOLA 8,000
PALM BEACH 9,000
PASCO 6,000
PINELLAS 9,000
POLK 8,000
PUTNAM 4,000
ST. JOHNS 0
SANTA ROSA 4,000
SARASOTA 3,000
SEMINOLE 4,000
SUMTER 0
SUWANNEE 0
TAYLOR 0
UNION 0
VOLUSIA 12,000
WALTON 0
WAKULLA 1,000
WASHINGTON 0
2. This amendment shall begin on February 24, 2004, or the date on which the
amendment has been signed by both parties, whichever is later.
All provisions in the Contract and any attachments thereto in conflict
with this amendment shall be and are hereby changed to conform with this
amendment.
All provisions not in conflict with this amendment are still in effect and
are to be performed at the level specified in the Contract.
This amendment and all its attachments are hereby made a part of the
Contract.
This amendment cannot be executed unless all previous amendments to this
Contract have been fully executed.
IN WITNESS WHEREOF, the parties hereto have caused this 2 page amendment
(including all attachments) to be executed by their officials thereunto duly
authorized.
HEALTHEASE of FLORIDA, INC STATE OF FLORIDA, AGENCY FOR
HEALTH CARE ADMINISTRATION
SIGNED SIGNED
BY: /s/ Todd S. Farha BY: /s/ Mary Pat Moore
------------------------------ ------------------------
NAME: Todd S. Farha NAME: Mary Pat Moore
TITLE: President & Chief Executive TITLE: INTERIM SECRETARY
Officer
DATE: 4/27/04 DATE: 5/03/04
AHCA CONTRACT NO. FA305, AMENDMENT NO. 010, PAGE 2 OF 2
HEALTHEASE OF FLORIDA,INC., d/b/a HEALTH EASE MEDICAID HMO CONTRACT
AHCA CONTRACT NO. FA305
AMENDMENT NO. 011
THIS AMENDMENT, entered into between the STATE OF FLORIDA, AGENCY FOR
HEALTH CARE ADMINISTRATION, hereinafter referred to as the "Agency" and
HEALTHEASE OF FLORIDA, INC., d/b/a HealthEase, hereinafter referred to as the
"Provider," is hereby amended as follows:
1. Attachment I, Section 10.11.5, Functional Assessments (Behavioral
Health), is amended to reduce FARS and CFARS outcome reporting from
quarterly to annually, as shown below.
The plan shall ensure its providers administer functional
assessments using the Functional Assessment Rating Scales(FARS)(for
persons over age 18) and Child Functional Rating Scale(CFARS)(for
persons age 18 and under). The plan shall ensure the provider
administers and maintains the FARS and CFARS for recipients of
behavioral health care services and upon termination of providing
such services . Additionally, the plan must evaluate these data and
report outcome measures to the agency on a annual basis by August
15.
2. The plan shall comply with the settlement for Hernandez, et al. v.
Medows, case number 02-20964(se Attachment II). The plan shall
ensure that its enrollees are receiving the functional equivalent of
those received by Medicaid fee-for-service recipients in accordance
with the Hernandez settlement.
3. Attachment I, Section 90.0, Payment and Authorized Enrollment
Levels, is amended effective July 1, 2003 as provided in Tables 2
and 3 shown below. Any capitation claims calculated based on rates
different than those indicated below are subject to recoupment in
accordance with Section 1.J, of the Standard Contract.
Table 2.
Area wide Age-banded Capitation Rates for all agency areas of the state other
than Area 6 and 1.
Area 0 2
01 year 1-5 6-13 14-20 Male 14-20 Female 21-54 Male 21-54 Female 55-64 65+
TANF/PC/SOBRA 261.91 63.76 40.04 45.16 98.44 113.35 173.96 263.42 263.42
SSI/NO/MEDICARE 1627.17 299.83 159.90 167.91 167.91 507.18 507.18 520.68 520.68
SSI/Part B 283.03 283.03 283.03 283.03 283.03 283.03 283.03 283.03 283.03
SSI/Part A & B 282.14 282.14 282.14 282.14 282.14 282.14 282.14 282.14 199.17
Area 03
01 year 1-5 6-13 14-20 Male 14-20 Female 21-54 Male 21-54 Female 55-64 65+
TANF/PC/SOBRA 304.04 74.58 47.33 53.30 115.21 132.40 204.22 310.61 310.61
SSI/NO/MEDICARE 1722.67 318.21 170.47 178.77 178.77 529.93 539.93 354.25 554.25
SSI/Part B 288.07 288.07 288.07 288.07 288.07 288.07 288.07 288.07 288.07
SSI/Part A & B 261.55 261.55 261.55 261.55 261.55 261.55 261.55 261.55 184.90
Area 04
01 year 1-5 6-13 14-20 Male 14-20 Female 21-54 Male 21-54 Female 55-64 65+
TANF/PC/SOBRA 272.14 66.78 42.37 47.98 103.10 118.94 183.29 279.31 279.31
SSI/NO/MEDICARE 1595.82 294.29 157.35 165.25 165.25 498.99 498.99 512.40 512.40
SSI/Part B 249.15 249.15 249.15 249.15 249.15 249.15 249.15 249.15 249.15
SSI/Part A & B 265.42 265.42 265.42 265.42 265.42 265.42 265.42 265.42 187.52
Area 05
01 year 1-5 6-13 14-20 Male 14-20 Female 21-54 Male 21-54 Female 55-64 65+
TANF/PC/SOBRA 285.33 69.91 44.12 49.25 107.97 123.86 191.30 290.61 290.61
SSI/NO/MEDICARE 1640.03 302.32 161.06 169.11 169.11 511.37 511.37 524.95 524.95
SSI/Part B 217.17 217.17 217.17 217.17 217.17 217.17 217.17 217.17 217.17
SSI/Part A & B 276.42 276.42 276.42 276.42 276.42 276.42 276.42 276.42 195.20
Area 07
01 year 1-5 6-13 14-20 Male 14-20 Female 21-54 Male 21-54 Male 55-64 65+
TANF/PC/SOBRA 279.36 68.56 43.44 49.09 105.94 121.92 188.01 286.09 286.09
SSI/NO/MEDICARE 1590.95 293.73 167.71 165.37 165.37 499.72 499.72 512.25 512.25
SSI/Part B 265.79 265.79 265.79 265.79 265.79 265.79 265.79 265.79 265.79
SSI/Part A & B 259.85 259.85 259.85 259.85 259.85 259.85 259.85 259.85 183.50
AHCA CONTRACT NO. FA305, AMENDMENT NO. 011, PAGE 1 OF 3
HEALTHEASE OF FLORIDA, INC., d/b/a HEALTHEASE MEDICAID HMO CONTRACT
Area 08
1 year 1-5 6-13 14-20 Male 14-20 Female 21-54 Male 21-54 Female 55-64 65+
TANP/FC/SOBRA 257.19 52.11 40.00 45.22 57.50 112.18 173.06 263.38 263.38
SSI/NO Medicare 1611.33 297.66 239.63 167.52 167.51 505.95 505.95 519.07 519.07
SSI/ Part B 250.97 250.97 250.97 250.97 250.97 250.97 250.97 250.97 250.97
SSI/ Part A & B 253.44 253.44 253.44 253.44 253.44 253.44 253.44 253.44 179.15
Area 09
1 year 1-5 6-13 14-20 Male 14-20 Female 21-54 Male 21-54 Female 55-64 65+
TANP/FC/SOBRA 278.08 68.26 43.21 68.86 105.44 121.17 286.89 284.35 284.35
SSI/NO Medicare 1801.74 333.04 179.03 187.98 187.98 567.15 567.15 581.73 581.73
SSI/ Part B 251.63 251.63 251.63 251.63 251.63 251.63 251.63 251.63 251.63
SSI/ Part A & B 290.09 290.09 290.09 290.09 290.09 290.09 290.09 290.09 204.83
Area 10
1 year 1-5 6-13 14-20 Male 14-20 Female 21-54 Male 21-54 Female 55-64 65+
TANP/FC/SOBRA 292.87 71.88 45.66 51.65 111.29 128.28 197.65 301.04 301.04
SSI/NO Medicare 2177.44 403.11 315.86 226.70 226.70 684.10 684.10 701.42 701.42
SSI/ Part B 267.12 267.12 267.12 267.12 267.12 267.12 267.12 267.12 267.12
SSI/ Part A & B 319.69 319.69 319.69 319.69 319.69 319.69 319.69 319.69 225.90
Area 11
1 year 1-5 6-13 14-20 Male 14-20 Female 21-54 Male 21-54 Female 55-64 65+
TANP/FC/SOBRA 347.50 85.26 53.83 60.83 131.65 150.81 232.98 353.25 353.25
SSI/NO Medicare 2349.00 427.18 233.39 245.61 245.61 744.91 744.91 760.78 760.78
SSI/ Part B 424.57 424.57 424.57 424.57 424.57 424.57 424.57 424.57 424.57
SSI/ Part A & B 367.79 367.79 367.79 367.79 367.79 367.79 367.79 367.79 256.40
Table 3.
Area 5 or Area 1 Age - banded Capitation Rates, Including Community Mental
Health and Mental Health Targeted Case Management.
Area 01
1 year 1-5 6-13 14-20 Male 14-20 Female 21-54 Male 21-54 Female 55-64 65+
TANP/FC/SOBRA 261.93 64.58 65.91 51.01 104.29 114.62 176.23 267.49 267.49
SSI/NO Medicare 1627.19 305.09 213.99 207.65 207.65 549.97 549.97 544.97 544.97
SSI/ Part B 289.84 289.84 289.84 289.84 289.84 289.84 289.84 289.84 289.84
SSI/ Part A & B 301.66 301.66 301.66 301.66 301.66 301.66 301.66 301.66 218.69
Area 05
1 year 1-5 6-13 14-20 Male 14-20 Female 21-54 Male 21-54 Female 55-64 65+
TANP/FC/SOBRA 279.29 71.17 59.81 65.79 122.52 124.65 190.77 289.28 289.28
SSI/NO Medicare 1498.70 293.07 243.27 196.57 196.57 526.87 526.87 511.41 511.41
SSI/ Part B 242.93 242.93 242.93 242.93 242.93 242.93 242.93 242.93 242.93
SSI/ Part A & B 263.55 263.55 263.55 263.55 263.55 263.55 263.55 263.55 187.50
4 This amendment shall begin on June 1, 2004 or the date on which the
amendment has been signed by both parties, whichever is later.
All provisions in the Contract and any attachments thereto in conflict with
this amendment shall be and are hereby changed to conform with this
amendment.
All provisions not in conflict with this amendment are still in effect and
are to be performed at the level specified in the Contract.
This amendment and all its attachments are hereby made a part of the
Contract.
This amendment cannot be executed unless all previous amendments to this
Contract have been fully executed.
AHCA CONTRACT NO. FA305, AMENDMENT NO. 011, PAGE 2 OF 3
HEALTHEASE OF FLORIDA, INC., d/b/a HEALTH EASE MEDICAID HMO CONTRACT
IN WITNESS WHEREOF, the parties hereto have caused this 3 page amendment
(including all attachments) to be executed by their officials thereunto duly
authorized.
HealthEase of Florida, Inc., STATE OF FLORIDA, AGENCY FOR
d/b/a HealthEase HEALTH CARE ADMINISTRATION
SIGNED SIGNED
BY: /s/ [ILLEGIBLE] BY: /s/ [ILLEGIBLE]
--------------------------------- -------------------------
FOR
NAME: [ILLEGIBLE] NAME: ALAN LEVINE
TITLE: SENIOR VICE PRESIDENT & TITLE: SECRETARY
GENERAL COUNSEL
DATE: 6/30/04 DATE: 6-30-04
THE REMAINDER OF THIS PAGE LEFT BLANK INTENTIONALLY
AHCA CONTRACT NO. FA305, AMENDMENT NO. 011, PAGE 3 OF 3