Common use of Appendix L, Sub-Capitation Program Rates for Primary Clause in Contracts

Appendix L, Sub-Capitation Program Rates for Primary. Care Entities, is hereby deleted and replaced with the attached Appendix L. Amendment #1 to the First Amended and Restated ACPP Contract Listed below are the Per Member Per Month (PMPM) Base Capitation Rates for Rate Year 2024 (January 1, 2024, through December 31, 2024) (also referred to as RY24), subject to state appropriation and all necessary federal approvals. Base Capitation Rates do not include EOHHS adjustments described in Section 4.3 of the Contract. In addition to the Base Capitation Rates tables below, additional tables include the add on for the Contract Year, for ABA Services as described in Section 4.5.E, for High Cost Drugs as described in Section 4.5.F and for SUD Risk Sharing Services as described in Section 4.5.G. The add on for High Cost Drugs, ABA Services and SUD Risk Sharing Services are the same for all Regions and will be added to the Risk Adjusted Capitation Rates as defined in Section 4.2.E. Effective January 1, 2024 – December 31, 2024 (RY24) REGION CORE MEDICAL COMPONENT ADMINISTRATIVE COMPONENT TOTAL BASE CAPITATION RATE (per member per month) (per member per month) (per member per month) Effective January 1, 2024 – December 31, 2024 (RY24) REGION CORE MEDICAL COMPONENT ADMINISTRATIVE COMPONENT TOTAL BASE CAPITATION RATE (per member per month) (per member per month) (per member per month) Effective January 1, 2024 – December 31, 2024 (RY24) REGION CORE MEDICAL COMPONENT ADMINISTRATIVE COMPONENT TOTAL BASE CAPITATION RATE (per member per month) (per member per month) (per member per month) Effective January 1, 2024 – December 31, 2024 (RY24) REGION CORE MEDICAL COMPONENT ADMINISTRATIVE COMPONENT TOTAL BASE CAPITATION RATE (per member per month) (per member per month) (per member per month) Effective January 1, 2024 – December 31, 2024 (RY24) REGION CORE MEDICAL COMPONENT ADMINISTRATIVE COMPONENT TOTAL BASE CAPITATION RATE (per member per month) (per member per month) (per member per month) Effective January 1, 2024 – December 31, 2024 (RY24) REGION CORE MEDICAL COMPONENT ADMINISTRATIVE COMPONENT TOTAL BASE CAPITATION RATE (per member per month) (per member per month) (per member per month) High Cost Drug Add On to Risk Adjusted Capitation Rates Effective January 1, 2024 – December 31, 2024 (RY24) High Cost Drug Add On to Risk Adjusted Capitation Rates PMPM

Appendix L, Sub-Capitation Program Rates for Primary. Care Entities, is hereby deleted and replaced with the attached Appendix L. Amendment #1 to the First Amended and Restated ACPP Contract Listed below are the Per Member Per Month (PMPM) Base Capitation Rates for Rate Year 2024 (January 1, 2024, 2024 through December 31, 2024) (also referred to as RY24), subject to state appropriation and all necessary federal approvals. Base Capitation Rates do not include EOHHS adjustments described in Section 4.3 of the Contract. In addition to the Base Capitation Rates tables below, additional tables include the add on for the Contract Year, for ABA Services as described in Section 4.5.E, for High Cost Drugs as described in Section 4.5.F and for SUD Risk Sharing Services as described in Section 4.5.G. The add on for High Cost Drugs, ABA Services and SUD Risk Sharing Services are the same for all Regions and will be added to the Risk Adjusted Capitation Rates as defined in Section 4.2.E. Effective January 1, 2024 – December 31, 2024 (RY24) REGION CORE MEDICAL COMPONENT ADMINISTRATIVE COMPONENT TOTAL BASE CAPITATION RATE (per member per month) (per member per month) (per member per month) Effective January 1, 2024 – December 31, 2024 (RY24) REGION CORE MEDICAL COMPONENT ADMINISTRATIVE COMPONENT TOTAL BASE CAPITATION RATE (per member per month) (per member per month) (per member per month) Effective January 1, 2024 – December 31, 2024 (RY24) REGION CORE MEDICAL COMPONENT ADMINISTRATIVE COMPONENT TOTAL BASE CAPITATION RATE (per member per month) (per member per month) (per member per month) Effective January 1, 2024 – December 31, 2024 (RY24) REGION CORE MEDICAL COMPONENT ADMINISTRATIVE COMPONENT TOTAL BASE CAPITATION RATE (per member per month) (per member per month) (per member per month) Effective January 1, 2024 – December 31, 2024 (RY24) REGION CORE MEDICAL COMPONENT ADMINISTRATIVE COMPONENT TOTAL BASE CAPITATION RATE (per member per month) (per member per month) (per member per month) Effective January 1, 2024 – December 31, 2024 (RY24) REGION CORE MEDICAL COMPONENT ADMINISTRATIVE COMPONENT TOTAL BASE CAPITATION RATE (per member per month) (per member per month) (per member per month) High Cost Drug Add On to Risk Adjusted Capitation Rates Effective January 1, 2024 – December 31, 2024 (RY24) High Cost Drug Add On to Risk Adjusted Capitation Rates PMPM

Appendix L, Sub-Capitation Program Rates for Primary. Care Entities, is hereby deleted and replaced with the attached Appendix L. Amendment #1 to the First Amended and Restated ACPP Contract Listed below are the Per Member Per Month (PMPM) Base Capitation Rates for Rate Year 2024 (January 1, 2024, through December 31, 2024) (also referred to as RY24), subject to state appropriation and all necessary federal approvals. Base Capitation Rates do not include EOHHS adjustments described in Section 4.3 of the Contract. In addition to the Base Capitation Rates tables below, additional tables include the add on for the Contract Year, for ABA Services as described in Section 4.5.E, for High Cost Drugs as described in Section 4.5.F and for SUD Risk Sharing Services as described in Section 4.5.G. The add on for High Cost Drugs, ABA Services and SUD Risk Sharing Services are the same for all Regions and will be added to the Risk Adjusted Capitation Rates as defined in Section 4.2.E. Effective January 1, 2024 – December 31, 2024 (RY24) REGION CORE MEDICAL COMPONENT ADMINISTRATIVE COMPONENT TOTAL BASE CAPITATION RATE (per member per month) (per member per month) (per member per month) Effective January 1, 2024 – December 31, 2024 (RY24) REGION CORE MEDICAL COMPONENT ADMINISTRATIVE COMPONENT TOTAL BASE CAPITATION RATE (per member per month) (per member per month) (per member per month) Effective January 1, 2024 – December 31, 2024 (RY24) REGION CORE MEDICAL COMPONENT ADMINISTRATIVE COMPONENT TOTAL BASE CAPITATION RATE (per member per month) (per member per month) (per member per month) Effective January 1, 2024 – December 31, 2024 (RY24) REGION CORE MEDICAL COMPONENT ADMINISTRATIVE COMPONENT TOTAL BASE CAPITATION RATE (per member per month) (per member per month) (per member per month) Effective January 1, 2024 – December 31, 2024 (RY24) REGION CORE MEDICAL COMPONENT ADMINISTRATIVE COMPONENT TOTAL BASE CAPITATION RATE (per member per month) (per member per month) (per member per month) Effective January 1, 2024 – December 31, 2024 (RY24) REGION CORE MEDICAL COMPONENT ADMINISTRATIVE COMPONENT TOTAL BASE CAPITATION RATE (per member per month) (per member per month) (per member per month) High Cost Drug Add On to Risk Adjusted Capitation Rates Effective January 1, 2024 – December 31, 2024 (RY24) High Cost Drug Add On to Risk Adjusted Capitation Rates PMPM)