AMENDMENT, EXTENSION, AND MODIFICATION. A. The contract may be amended, extended, or modified by written contract duly executed by the Director and the contractor. Any such amendment, extension or modification shall be in writing and executed by the parties hereto. It is mutually understood and agreed that no amendment of the terms of the contract shall be valid unless reduced to writing and executed by the parties hereto, and that no oral understandings, representations or contracts not incorporated herein nor any oral alteration or variations of the terms hereof, shall be binding on the parties hereto. Every such amendment, extension, or modification shall specify the date its provisions shall be effective as agreed to by the Department and the contractor. Any amendment, extension, or modification is not effective or binding unless approved, in writing, by duly authorized officials of DHS, HCFA, and any other entity, as required by law or regulation. B. This contract may be extended for successive twelve (12) month periods beyond the original term of the contract whenever the Division supplies the contractor with at least ninety (90) days advance notice of such intent and if a written amendment to extend the contract is obtained from both parties. This successive twelve (12) month period shall be known as an "extension period" of the contract. In addition, ninety (90) days prior to the contract expiration, the Director shall provide the contractor with the proposed capitation rates for the extension period. C. In the event that the capitation rates for the extension period are not provided ninety (90) days prior to the contract expiration, the contract will be extended at the existing rate which shall be an interim rate. After the execution of the succeeding rate amendment, a retroactive rate adjustment will be made to bring the interim rate to the level established by that amendment. D. The contractor shall begin providing services to all populations covered under this contract on October 1, 2000. The State shall pay the contractor the capitation rates set forth in Appendix C, except for the following premium groups: 1. DDD With Medicare 2. DDD Without Medicare (ABD) 3. DDD Without Medicare (non-ABD) 4. AIDS - ABD With Medicare 5. AIDS &DDD - ABD With Medicare 6. AFDC - AIDS 7. AFDC - AIDS &DDD 8. Blind/Disabled With Medicare, < 45 M &F 9 Blind/Disabled With Medicare, 45+ M &F For those enrollees who are members of the contractor's plan as of October 1, 2000 and who are subsequently identified by the State as members of one of the above premium groups, the State may initially pay the contractor the following capitation rates: PREMIUM GROUP INTERIM RATE ------------- ------------
Appears in 1 contract
AMENDMENT, EXTENSION, AND MODIFICATION. A. The contract may be amended, extended, or modified by written contract duly executed by the Director and the contractor. Any such amendment, extension or modification shall be in writing and executed by the parties hereto. It is mutually understood and agreed that no amendment of the terms of the contract shall be valid unless reduced to writing and executed by the parties hereto, and that no oral understandings, representations or contracts not incorporated herein nor any oral alteration or variations of the terms hereof, shall be binding on the parties hereto. Every such amendment, extension, or modification shall specify the date its provisions shall be effective as agreed to by the Department and the contractor. Any amendment, extension, or modification is not effective or binding unless approved, in writing, by duly authorized officials of DHS, HCFA, and any other entity, as required by law or regulation.
B. This contract may be extended for successive twelve (12) month periods beyond the original term of the contract whenever the Division supplies the contractor with at least ninety (90) days advance notice of such intent and if a written amendment to extend the contract is obtained from both parties. This successive twelve (12) month period shall be known as an "extension period" of the contract. In addition, ninety (90) days prior to the contract expiration, the Director shall provide the contractor with the proposed capitation rates for the extension period.
C. In the event that the capitation rates for the extension period are not provided ninety (90) days prior to the contract expiration, the contract will be extended at the existing rate which shall be an interim rate. After the execution of the succeeding rate amendment, a retroactive rate adjustment will be made to bring the interim rate to the level established by that amendment.
D. The contractor shall begin providing services to all populations covered under this contract on October 1, 2000. The State shall pay the contractor the capitation rates set forth in Appendix C, except for the following premium groups:
1. DDD With Medicare Medicare
2. DDD Without Medicare (ABD) )
3. DDD Without Medicare (non-ABD) )
4. AIDS - ABD With Medicare Medicare
5. AIDS && DDD - ABD With Medicare Medicare
6. AFDC - AIDS AIDS
7. AFDC - AIDS &DDD & DDD
8. Blind/Disabled With Medicare, < 45 M &F 9 & F
9. Blind/Disabled With Medicare, 45+ M && F For those enrollees who are members of the contractor's plan as of October 1, 2000 and who are subsequently identified by the State as members of one of the above premium groups, the State may initially pay the contractor the following capitation rates: ------------------------------------------------------------------------------------- PREMIUM GROUP INTERIM RATE ------------- ------------------------------------------------------------------------------------------------- DDD With Medicare Aged with Medicare ------------------------------------------------------------------------------------- DDD Without Medicare (ABD) ABD (including AIDS) Without Medicare ------------------------------------------------------------------------------------- DDD Without Medicare (non-ABD) ABD (including AIDS) Without Medicare ------------------------------------------------------------------------------------- AIDS - ABD With Medicare ABD (including AIDS) Without Medicare ------------------------------------------------------------------------------------- AIDS & DDD - ABD With Medicare ABD (including AIDS) Without Medicare ------------------------------------------------------------------------------------- AFDC - AIDS ABD (including AIDS) Without Medicare ------------------------------------------------------------------------------------- AFDC - AIDS & DDD ABD (including AIDS) Without Medicare ------------------------------------------------------------------------------------- Blind/Disabled With Medicare, < 45 M & F Aged With Medicare ------------------------------------------------------------------------------------- Blind/Disabled With Medicare, 45+ M & F Aged With Medicare ------------------------------------------------------------------------------------- The State shall retroactively adjust these payments to reflect the premium rate for these enrollees.
E. Nothing in this Article shall be construed to prevent the Director by amendment to the contract from extending the contract on a month to month basis under the existing rates until such a time that the Director provides revised capitation rates pursuant to Article 7.11.2B.
Appears in 1 contract
AMENDMENT, EXTENSION, AND MODIFICATION. A. The contract may be amended, extended, or modified by written contract duly executed by the Director and the contractor. Any such amendment, extension or modification shall be in writing and executed by the parties hereto. It is mutually understood and agreed that no amendment of the terms of the contract shall be valid unless reduced to writing and executed by the parties hereto, and that no oral VII-11 236 understandings, representations or contracts not incorporated herein nor any oral alteration or variations of the terms hereof, shall be binding on the parties hereto. Every such amendment, extension, or modification shall specify the date its provisions shall be effective as agreed to by the Department and the contractor. Any amendment, extension, or modification is not effective or binding unless approved, in writing, by duly authorized officials of DHS, HCFA, and any other entity, as required by law or regulation.
B. This contract may be extended for successive twelve (12) month periods beyond the original term of the contract whenever the Division supplies the contractor with at least ninety (90) days advance notice of such intent and if a written amendment to extend the contract is obtained from both parties. This successive twelve (12) month period shall be known as an "extension period" of the contract. In addition, ninety (90) days prior to the contract expiration, the Director shall provide the contractor with the proposed capitation rates for the extension period.
C. In the event that the capitation rates for the extension period are not provided ninety (90) days prior to the contract expiration, the contract will be extended at the existing rate which shall be an interim rate. After the execution of the succeeding rate amendment, a retroactive rate adjustment will be made to bring the interim rate to the level established by that amendment.
D. The contractor shall begin providing services to all populations covered under this contract on October 1, 2000. The State shall pay the contractor the capitation rates set forth in Appendix C, except for the following premium groups:
1. DDD With Medicare 2. DDD Without Medicare (ABD) 3. DDD Without Medicare (non-ABD) 4. AIDS - ABD With Medicare 5. AIDS && DDD - ABD With Medicare 6. AFDC - AIDS 7. AFDC - AIDS && DDD 8. Blind/Disabled With Medicare, < less than 45 M && F 9 9. Blind/Disabled With Medicare, 45+ M && F For those enrollees who are members of the contractor's plan as of October 1, 2000 and who are subsequently identified by the State as members of one of the above premium groups, the State may initially pay the contractor the following capitation rates: VII-12 237 PREMIUM GROUP INTERIM RATE ------------- ------------------------ DDD With Medicare Aged with Medicare DDD Without Medicare (ABD) ABD (including AIDS) Without Medicare DDD Without Medicare (non-ABD) ABD (including AIDS) Without Medicare AIDS - ABD With Medicare ABD (including AIDS) Without Medicare AIDS & DDD - ABD With ABD (including AIDS) Without Medicare Medicare AFDC - AIDS ABD (including AIDS) Without Medicare AFDC - AIDS & DDD ABD (including AIDS) Without Medicare Blind/Disabled With Medicare, Aged With Medicare less than 45 M & F Blind/Disabled With Medicare, 45+ Aged With Medicare M & F The State shall retroactively adjust these payments to reflect the premium rate for these enrollees.
E. Nothing in this Article shall be construed to prevent the Director by amendment to the contract from extending the contract on a month to month basis under the existing rates until such a time that the Director provides revised capitation rates pursuant to Article 7.11.2B.
Appears in 1 contract
AMENDMENT, EXTENSION, AND MODIFICATION. A. The contract may be amended, extended, or modified by written contract duly executed by the Director and the contractor. Any such amendment, extension or modification shall be in writing and executed by the parties hereto. It is mutually understood and agreed that no amendment of the terms of the contract shall be valid unless reduced to writing and executed by the parties hereto, and that no oral understandings, representations or contracts not incorporated herein nor any oral alteration or variations of the terms hereof, shall be binding on the parties hereto. Every such amendment, extension, or modification shall specify the date its provisions shall be effective as agreed to by the Department and the contractor. Any amendment, extension, or modification is not effective or binding unless approved, in writing, by duly authorized officials of DHS, HCFACMS, and any other entity, as required by law or regulation.
B. This contract may be extended for successive twelve (12) month periods beyond the original term of the contract whenever the Division supplies the contractor with at least ninety (90) days advance notice of such intent and if a written amendment to extend the contract is obtained from both parties. This successive twelve (12) month period shall be known as an "extension period" of the contract. In addition, ninety (90) days prior to the contract expiration, the Director The Department shall provide the contractor with advanced notice of changes or amendments unless the proposed capitation rates for the extension periodchanges are due to a change in law, including budget appropriation, or regulation, and it is not possible to provide such notice.
C. B. In the event that the capitation premium rates for the extension period are not provided ninety (90) days prior to the contract expiration, the contract will be extended at the existing rate which shall be an interim rate. After the execution of the succeeding rate amendment, a retroactive rate adjustment will be made to bring the interim rate to the level established by that amendment.
D. The contractor C. Nothing in this Article shall begin providing services be construed to all populations covered under this prevent the Director by amendment to the contract from extending the contract on October 1, 2000. The State shall pay a month to month basis under the contractor existing rates until such a time that the capitation Director provides revised premium rates set forth in Appendix C, except for the following premium groups:
1. DDD With Medicare 2. DDD Without Medicare (ABD) 3. DDD Without Medicare (non-ABD) 4. AIDS - ABD With Medicare 5. AIDS &DDD - ABD With Medicare 6. AFDC - AIDS 7. AFDC - AIDS &DDD 8. Blind/Disabled With Medicare, < 45 M &F 9 Blind/Disabled With Medicare, 45+ M &F For those enrollees who are members of the contractor's plan as of October 1, 2000 and who are subsequently identified by the State as members of one of the above premium groups, the State may initially pay the contractor the following capitation rates: PREMIUM GROUP INTERIM RATE ------------- ------------pursuant to Article 7.11.2B.
Appears in 1 contract
