Exhibit 10.7.3
REGULATORY ALERT
[LETTERHEAD] OF AMERIGROUP CORPORATION
MEMORANDUM
TO: Distribution
FROM: Kimberly Chope, Regulatory Compliance
DATE: July 23, 2002
SUBJECT: ILLINOIS CONTRACT AMENDMENT
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Attached please find a copy of an amendment to the contract between AMERIGROUP
Illinois, Inc. and the Illinois Department of Public Aid. Please review the
overall summary below and the attached amendment to determine the impact to
AMERIGROUP and/or our vendors.
OVERALL SUMMARY:
This amendment reflects a 1.5% rate reduction to each age and gender cell,
effective July 1, 2002. The rate sheets are attached.
Additionally, one new section has been added to the contract whereby AMERIGROUP
certifies it is not delinquent in the payment of any debt to the State.
FOLLOW UP REQUIRED:
[ ] Response required back to Regulatory Manager by [date]
[XX] Informational only. Response is not required.
If you have further questions or concerns regarding this request, please contact
Kim Chope, extension 2722.
Distribution
[GRAPHIC] Illinois Department of Public Aid
201 South Grand Avenue East
Springfield, Illinois 62763-0001
George H. Ryan, Governor Telephone: (217) 782-1200
Jackie Garner, Director TTY: (800) 526-5812
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RECEIVED
JULY - 8 2002
---------------
July 5, 2002
Dwight Jones, M.D.
President and CEO
AMERIGROUP Illinois, Inc.
211 W. Wacker Drive, Suite #1350
Chicago, IL 60606
Dear Dr. Jones,
Enclosed please find four originals of an amendment to the Contract for
Furnishing Health Services between AMERIGROUP Illinois, Inc. and the Department.
This amendment reflects a 1.5% rate reduction to each age and gender cell,
effective July 1, 2002.
Please have all four originals completed and signed, and return them to my
attention as soon as possible.
If you have any questions, please feel free to contact me at (217) 524-7478.
Sincerely,
/s/ Nelly Ryan
- ----------------------------------
Nelly Ryan, Deputy Administrator
Division of Medical Programs
Attachments
E-mail: dpawebmaster@state.il.us Internet: http://www.state.il.us/dpa/
[GRAPHIC] Illinois Department of Public Aid
201 South Grand Avenue East
Springfield, Illinois 62763-0001
George H. Ryan, Governor Telephone: (217) 782-1200
Jackie Garner, Director TTY: (800) 526-5812
---------------
RECEIVED
AUG 26 2002
---------------
August 22, 2002
Dwight Jones, M.D.
President and CEO
AMERIGROUP Illinois, Inc.
211 West Wacker Drive, Suite 1350
Chicago, Illinois 60606
Dear Dr. Jones:
Enclosed for your files is one original signature copy of the amendment to the
Contract for Furnishing Health Services which reflects a 1.5% rate, reduction
effective July 1, 2002.
Sincerely,
/s/ Nelly Ryan
- ----------------------------------
Nelly Ryan, Deputy Administrator
Division of Medical Programs
Enclosure
E-mail: dpawebmaster@state.il.us Internet: http://www.state.il.us/dpa/
STATE OF ILLINOIS
DEPARTMENT OF PUBLIC AID
AMENDMENT NO. 4 TO THE
CONTRACT FOR FURNISHING HEALTH SERVICES
BY A
HEALTH MAINTENANCE ORGANIZATION
2001-24-006-KA4
Whereas, the parties to the Contract for Furnishing Health Services by a Health
Maintenance Organization ("CONTRACT"), the Illinois Department of Public Aid,
201 South Grand Avenue East, Springfield, Illinois 62763-0001 (herein referred
to as "Department"), acting by and through its Director, and AMERIGROUP
Illinois, Inc., formerly known as AMERICAID Illinois, Inc. d/b/a/ Americaid
Community Care, (hereinafter referred to as "Contractor"), desire to amend the
CONTRACT; and
Whereas, pursuant to Article 9, Section 9.9 (a) of the CONTRACT, the CONTRACT
may be modified or amended by the mutual consent of the parties; and
Whereas, pursuant to Article 9, Section 9.9 (c) of the CONTRACT, the CONTRACT
must be amended if and when required to comply with federal or state laws or
regulations and the Department has determined that the Contract must be amended
in order to insert the Non-Delinquency Certification clause required by 30 ILCS
500/50-11;
NOW THEREFORE, the CONTRACT shall be amended as follows:
1. Second Amended Attachment I shall be deleted and replaced by the
attached Third Amended Attachment I. Each reference to Second Amended
Attachment I in the CONTRACT shall be deemed to refer to Third Amended
Attachment I.
2. Article 9 is amended by inserting a new section 9.43, Non-Delinquency
Certification, to read as follows:
9.43 Non-Delinquency Certification
Contractor certifies that Contractor is not delinquent in the payment
of any debt to the State and, therefore, is not barred from being
awarded a contract under 30 ILCS 500/50-11. Contractor acknowledges
that the Department may declare the contract void if this
certification is false, or if Contractor is determined to be
delinquent in the payment of any debt to the State during the term of
the contract.
All other terms and conditions of the CONTRACT shall remain in full force
and effect.
-1-
IN WITNESS WHEREOF, the parties have hereunto caused this agreement to
amend the CONTRACT to be executed by their duly authorized representatives,
effective July 1, 2002.
DAPARTMENT OF PUBLIC AID AMERIGROUP Illinois, Inc.
By: /s/ Jackie Garner By: /s/ Dwight E. Jones
----------------------------------- ----------------------------------
Jackie Garner
Printed Name: Dwight E. Jones
Title: Director Title: Pres & CEO
Date: 8-18-02 Date: 7/18/02
FEIN:
--------------------------------
-2-
THIRD AMENDED ATTACHMENT I
RATE SHEETS
(a) Contractor Name: AMERIGROUP Illinois, Inc.
Address: 211 W. Wacker Drive, Suite #1350
Chicago, IL 60606
(b) Contracting Area(s) Covered by the Contractor and Enrollment Limit:
- --------------------------------------------------------------------------------
Contracting Area Enrollment Limit
- --------------------------------------------------------------------------------
Region IV 100,000
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
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(c) Total Enrollment Limit for all Contracting Areas: 100,000
(d) Threshold Review Levels: 80,000
Att. I-1
(e) Standard Capitation Rates for MAG Beneficiaries for each Region for April 1,
2000 through June 30, 2000:
- -----------------------------------------------------------------------
Region I Region II Region III Region IV Region V
(N.W. (Central (Southern (Cook (Collar
Illinois) Illinois) Illinois) County) Counties)
Age/Gender PMPM PMPM PMPM PMPM PMPM
- -----------------------------------------------------------------------
0-2 F $214.19 $149.47 $206.08 $254.29 $181.15
- -----------------------------------------------------------------------
0-2 M $242.48 $183.18 $263.92 $300.07 $183.68
- -----------------------------------------------------------------------
3-13 F $ 39.63 $ 41.98 $ 47.02 $ 40.55 $ 32.21
- -----------------------------------------------------------------------
3-13 M $ 47.40 $ 52.61 $ 55.95 $ 49.60 $ 40.28
- -----------------------------------------------------------------------
14-20 F $209.65 $181.58 $204.84 $169.14 $167.32
- -----------------------------------------------------------------------
14-20 M $ 74.37 $ 70.44 $ 75.51 $ 63.46 $ 46.99
- -----------------------------------------------------------------------
21-44 F $201.77 $186.87 $206.99 $203.22 $181.66
- -----------------------------------------------------------------------
21-44 M $100.41 $111.11 $132.34 $148.11 $102.05
- -----------------------------------------------------------------------
45+ F $324.75 $292.50 $269.83 $245.81 $236.39
- -----------------------------------------------------------------------
45+ M $195.92 $304.26 $291.83 $221.72 $177.78
- -----------------------------------------------------------------------
Certified Local Health Department add-on: To be determined.
Standard Capitation Rates for MAG Beneficiaries for each Region for July 1, 2000
through December 31, 2001:
- -----------------------------------------------------------------------
Region I Region II Region III Region IV Region V
(N.W. (Central (Southern (Cook (Collar
Illinois) Illinois) Illinois) County) Counties)
Age/Gender PMPM PMPM PMPM PMPM PMPM
- -----------------------------------------------------------------------
0-2 F $218.47 $152.46 $210.20 $259.38 $184.77
- -----------------------------------------------------------------------
0-2 M $247.33 $186.84 $269.20 $306.07 $187.35
- -----------------------------------------------------------------------
3-13 F $ 40.42 $ 42.82 $ 47.96 $ 41.36 $ 32.85
- -----------------------------------------------------------------------
3-13 M $ 48.35 $ 53.66 $ 57.07 $ 50.59 $ 41.09
- -----------------------------------------------------------------------
14-20 F $213.84 $185.21 $208.94 $172.52 $170.67
- -----------------------------------------------------------------------
14-20 M $ 75.86 $ 71.85 $ 77.02 $ 64.73 $ 47.93
- -----------------------------------------------------------------------
21-44 F $205.81 $190.61 $211.13 $207.28 $185.29
- -----------------------------------------------------------------------
21-44 M $102.42 $113.33 $134.99 $151.07 $104.09
- -----------------------------------------------------------------------
45+ F $331.25 $298.35 $275.23 $250.73 $241.12
- -----------------------------------------------------------------------
45+ M $199.84 $310.35 $297.67 $226.15 $181.34
- -----------------------------------------------------------------------
Certified Local Health Department add-on: To be determined.
Att. I-2
Standard Capitation Rates for MAG Beneficiaries for each Region for January 1,
2002 through June 30, 2002:
- -----------------------------------------------------------------------
Region I Region II Region III Region IV Region V
(N.W. (Central (Southern (Cook (Collar
Illinois) Illinois) Illinois) County) Counties)
Age/Gender PMPM PMPM PMPM PMPM PMPM
- -----------------------------------------------------------------------
0-2 F $208.64 $145.60 $200.74 $247.71 $176.46
- -----------------------------------------------------------------------
0-2 M $236.20 $178.43 $257.09 $292.30 $178.92
- -----------------------------------------------------------------------
3-13 F $ 38.60 $ 40.89 $ 45.80 $ 39.50 $ 31.37
- -----------------------------------------------------------------------
3-13 M $ 46.17 $ 51.25 $ 54.50 $ 48.31 $ 39.24
- -----------------------------------------------------------------------
14-20 F $204.22 $176.88 $199.54 $164.76 $162.99
- -----------------------------------------------------------------------
14-20 M $ 72.45 $ 68.62 $ 73.55 $ 61.82 $ 45.77
- -----------------------------------------------------------------------
21-44 F $196.55 $182.03 $201.63 $197.95 $176.95
- -----------------------------------------------------------------------
21-44 M $ 97.81 $108.23 $128.92 $144.27 $ 99.41
- -----------------------------------------------------------------------
45+ F $316.34 $284.92 $262.84 $239.45 $230.27
- -----------------------------------------------------------------------
45+ M $190.85 $296.38 $284.27 $215.97 $173.18
- -----------------------------------------------------------------------
Certified Local Health Department add-on: To be determined.
Standard Capitation Rates for MAG Beneficiaries for each Region beginning July
1, 2002:
- -----------------------------------------------------------------------
Region I Region II Region III Region IV Region V
(N.W. (Central (Southern (Cook (Collar
Illinois) Illinois) Illinois) County) Counties)
Age/Gender PMPM PMPM PMPM PMPM PMPM
- -----------------------------------------------------------------------
0-2 F $205.51 $143.42 $197.73 $243.99 $173.81
- -----------------------------------------------------------------------
0-2 M $232.66 $175.75 $253.23 $287.92 $176.24
- -----------------------------------------------------------------------
3-13 F $ 38.02 $ 40.28 $ 45.11 $ 38.91 $ 30.90
- -----------------------------------------------------------------------
3-13 M $ 45.48 $ 50.48 $ 53.68 $ 47.59 $ 38.65
- -----------------------------------------------------------------------
14-20 F $201.16 $174.23 $196.55 $162.29 $160.55
- -----------------------------------------------------------------------
14-20 M $ 71.36 $ 67.59 $ 72.45 $ 60.89 $ 45.08
- -----------------------------------------------------------------------
21-44 F $193.60 $179.30 $198.61 $194.98 $174.30
- -----------------------------------------------------------------------
21-44 M $ 96.34 $106.61 $126.99 $142.11 $ 97.92
- -----------------------------------------------------------------------
45+ F $311.59 $280.65 $258.90 $235.86 $226.82
- -----------------------------------------------------------------------
45+ M $187.99 $291.93 $280.01 $212.73 $170.58
- -----------------------------------------------------------------------
Certified Local Health Department add-on: To be determined.
Att. I-3
(f) Standard Capitation Rates for MANG Beneficiaries for each Region for April
1, 2000 through June 30, 2000:
- -----------------------------------------------------------------------
Region I Region II Region III Region IV Region V
(N.W. (Central (Southern (Cook (Collar
Illinois) Illinois) Illinois) County) Counties)
Age/Gender PMPM PMPM PMPM PMPM PMPM
- -----------------------------------------------------------------------
0-2 F $277.63 $270.73 $276.42 $221.95 $175.33
- -----------------------------------------------------------------------
0-2 M $337.39 $320.77 $236.83 $259.94 $203.36
- -----------------------------------------------------------------------
3-13 F $ 46.02 $ 44.62 $ 52.51 $ 43.55 $ 39.42
- -----------------------------------------------------------------------
3-13 M $ 58.45 $ 63.44 $ 67.51 $ 55.10 $ 51.37
- -----------------------------------------------------------------------
14-20 F $260.15 $234.40 $246.15 $238.15 $260.81
- -----------------------------------------------------------------------
14-20 M $ 79.62 $119.09 $121.82 $ 82.31 $181.38
- -----------------------------------------------------------------------
21-44 F $245.64 $245.87 $226.89 $266.25 $244.39
- -----------------------------------------------------------------------
21-44 M $145.22 $107.80 $103.83 $ 98.85 $119.40
- -----------------------------------------------------------------------
45+ F $279.44 $329.92 $300.30 $255.70 $270.54
- -----------------------------------------------------------------------
45+ M $340.30 $205.30 $239.31 $247.28 $292.90
- -----------------------------------------------------------------------
Certified Local Health Department add-on: To be determined.
Standard Capitation Rates for MANG Beneficiaries for each Region for July 1,
2000 through December 31, 2001:
- -----------------------------------------------------------------------
Region I Region II Region III Region IV Region V
(N.W. (Central (Southern (Cook (Collar
Illinois) Illinois) Illinois) County) Counties)
Age/Gender PMPM PMPM PMPM PMPM PMPM
- -----------------------------------------------------------------------
0-2 F $283.18 $276.14 $281.95 $226.39 $178.84
- -----------------------------------------------------------------------
0-2 M $344.14 $327.19 $241.57 $265.14 $207.43
- -----------------------------------------------------------------------
3-13 F $ 46.94 $ 45.51 $ 53.56 $ 44.42 $ 40.21
- -----------------------------------------------------------------------
3-13 M $ 59.62 $ 64.71 $ 68.86 $ 56.20 $ 52.40
- -----------------------------------------------------------------------
14-20 F $265.35 $239.09 $251.07 $242.91 $266.03
- -----------------------------------------------------------------------
14-20 M $ 81.21 $121.47 $124.26 $ 83.96 $185.01
- -----------------------------------------------------------------------
21-44 F $250.55 $250.79 $231.43 $271.58 $249.28
- -----------------------------------------------------------------------
21-44 M $148.12 $109.96 $105.91 $100.83 $121.79
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45+ F $285.03 $336.52 $306.31 $260.81 $275.95
- -----------------------------------------------------------------------
45+ M $347.11 $209.41 $244.10 $252.23 $298.76
- -----------------------------------------------------------------------
Certified Local Health Department add-on: To be determined.
Att. I - 4
Standard Capitation Rates for MANG Beneficiaries for each Region for January 1,
2002 through June 30, 2002:
- -----------------------------------------------------------------------
Region I Region II Region III Region IV Region V
(N.W. (Central (Southern (Cook (Collar
Illinois) Illinois) Illinois) County) Counties)
Age/Gender PMPM PMPM PMPM PMPM PMPM
- -----------------------------------------------------------------------
0-2 F $270.44 $263.71 $269.26 $216.20 $170.79
- -----------------------------------------------------------------------
0-2 M $328.65 $312.47 $230.70 $253.21 $198.10
- -----------------------------------------------------------------------
3-13 F $ 44.83 $ 43.46 $ 51.15 $ 42.42 $ 38.40
- -----------------------------------------------------------------------
3-13 M $ 56.94 $ 61.80 $ 65.76 $ 53.67 $ 50.04
- -----------------------------------------------------------------------
14-20 F $253.41 $228.33 $239.77 $231.98 $254.06
- -----------------------------------------------------------------------
14-20 M $ 77.56 $116.00 $118.67 $ 80.18 $176.68
- -----------------------------------------------------------------------
21-44 F $239.28 $239.50 $221.02 $259.36 $238.06
- -----------------------------------------------------------------------
21-44 M $141.45 $105.01 $101.14 $ 96.29 $116.31
- -----------------------------------------------------------------------
45+ F $272.20 $321.38 $292.53 $249.07 $263.53
- -----------------------------------------------------------------------
45+ M $331.49 $199.99 $233.12 $244.88 $285.32
- -----------------------------------------------------------------------
Certified Local Health Department add-on: To be determined.
Standard Capitation Rates for MANG Beneficiaries for each Region beginning July
1, 2002:
- -----------------------------------------------------------------------
Region I Region II Region III Region IV Region V
(N.W. (Central (Southern (Cook (Collar
Illinois) Illinois) Illinois) County) Counties)
Age/Gender PMPM PMPM PMPM PMPM PMPM
- -----------------------------------------------------------------------
0-2 F $266.38 $259.75 $265.22 $212.96 $168.23
- -----------------------------------------------------------------------
0-2 M $323.72 $307.78 $227.24 $249.41 $195.13
- -----------------------------------------------------------------------
3-13 F $ 44.16 $ 42.81 $ 50.38 $ 41.78 $ 37.82
- -----------------------------------------------------------------------
3-13 M $ 56.09 $ 60.87 $ 64.77 $ 52.86 $ 49.29
- -----------------------------------------------------------------------
14-20 F $249.61 $224.91 $236.17 $228.50 $250.25
- -----------------------------------------------------------------------
14-20 M $ 76.40 $114.26 $116.89 $ 78.98 $174.03
- -----------------------------------------------------------------------
21-44 F $235.69 $235.91 $217.70 $255.47 $234.49
- -----------------------------------------------------------------------
21-44 M $139.33 $103.43 $ 99.62 $ 94.85 $114.57
- -----------------------------------------------------------------------
45+ F $268.12 $316.56 $288.14 $245.33 $259.58
- -----------------------------------------------------------------------
45+ M $326.52 $196.99 $229.62 $237.27 $281.04
- -----------------------------------------------------------------------
Certified Local Health Department add-on: To be determined.
Att. I - 5
(g) Standard Capitation Rates for KidCare Participants for each Region for April
1, 2000 through June 30, 2000:
- -----------------------------------------------------------------------
Region I Region II Region III Region IV Region V
(N.W. (Central (Southern (Cook (Collar
Illinois) Illinois) Illinois) County) Counties)
Age/Gender PMPM PMPM PMPM PMPM PMPM
- -----------------------------------------------------------------------
1-2 F $66.34 $67.54 $73.13 $74.63 $60.58
- -----------------------------------------------------------------------
1-2 M $92.26 $75.87 $96.90 $86.82 $73.08
- -----------------------------------------------------------------------
3-13 F $39.25 $41.38 $46.47 $40.71 $32.31
- -----------------------------------------------------------------------
3-13 M $47.00 $51.79 $55.68 $49.87 $40.63
- -----------------------------------------------------------------------
14-18 F $87.57 $85.98 $99.19 $77.53 $73.22
- -----------------------------------------------------------------------
14-18 M $73.14 $69.51 $75.56 $63.48 $46.69
- -----------------------------------------------------------------------
Certified Local Health Department add-on: To be determined.
Standard Capitation Rates for KidCare Participants for each Region for July 1,
2000 through December 31, 2001:
- -----------------------------------------------------------------------
Region I Region II Region III Region IV Region V
(N.W. (Central (Southern (Cook (Collar
Illinois) Illinois) Illinois) County) Counties)
Age/Gender PMPM PMPM PMPM PMPM PMPM
- -----------------------------------------------------------------------
1-2 F $67.67 $68.89 $ 74.59 $76.12 $61.79
- -----------------------------------------------------------------------
1-2 M $94.11 $77.39 $ 98.84 $88.56 $74.54
- -----------------------------------------------------------------------
3-13 F $40.04 $42.21 $ 47.40 $41.52 $32.96
- -----------------------------------------------------------------------
3-13 M $47.94 $52.83 $ 56.79 $50.87 $41.44
- -----------------------------------------------------------------------
14-18 F $89.32 $87.70 $101.17 $79.08 $74.68
- -----------------------------------------------------------------------
14-18 M $74.60 $70.90 $ 77.07 $64.75 $47.62
- -----------------------------------------------------------------------
Certified Local Health Department add-on: To be determined.
Att. I - 6
Standard Capitation Rates for KidCare Participants for each Region for January
1, 2002 through June 30, 2002:
- -----------------------------------------------------------------------
Region I Region II Region III Region IV Region V
(N.W. (Central (Southern (Cook (Collar
Illinois) Illinois) Illinois) County) Counties)
Age/Gender PMPM PMPM PMPM PMPM PMPM
- -----------------------------------------------------------------------
1-2 F $64.62 $65.79 $71.23 $72.69 $59.01
- -----------------------------------------------------------------------
1-2 M $89.88 $73.91 $94.39 $84.57 $71.19
- -----------------------------------------------------------------------
3-13 F $38.24 $40.31 $45.27 $39.65 $31.48
- -----------------------------------------------------------------------
3-13 M $45.78 $50.45 $54.23 $48.58 $39.58
- -----------------------------------------------------------------------
14-18 F $85.30 $83.75 $96.62 $75.52 $71.32
- -----------------------------------------------------------------------
14-18 M $71.24 $67.71 $73.60 $61.84 $45.48
- -----------------------------------------------------------------------
Certified Local Health Department add-on: To be determined.
Standard Capitation Rates for KidCare Participants for each Region beginning
July 1, 2002:
- -----------------------------------------------------------------------
Region I Region II Region III Region IV Region V
(N.W. (Central (Southern (Cook (Collar
Illinois) Illinois) Illinois) County) Counties)
Age/Gender PMPM PMPM PMPM PMPM PMPM
- -----------------------------------------------------------------------
1-2 F $63.65 $64.80 $70.16 $71.60 $58.12
- -----------------------------------------------------------------------
1-2 M $88.53 $72.80 $92.97 $83.30 $70.12
- -----------------------------------------------------------------------
3-13 F $37.67 $39.71 $44.59 $39.06 $31.01
- -----------------------------------------------------------------------
3-13 M $45.09 $49.69 $53.42 $47.85 $38.99
- -----------------------------------------------------------------------
14-18 F $84.02 $82.49 $95.17 $74.39 $70.25
- -----------------------------------------------------------------------
14-18 M $70.17 $66.69 $72.50 $60.91 $44.80
- -----------------------------------------------------------------------
Certified Local Health Department add-on: To be determined.
Att. I - 7