Common use of Payment of Direct Capitation for Coverage of Integrated Medicaid Benefits Clause in Contracts

Payment of Direct Capitation for Coverage of Integrated Medicaid Benefits. (HIDE): AHCCCS reimburses the MAO’s companion AHCCCS Complete Care (ACC), ALTCS DD, or RBHA health plan as structured per subparagraph 2.12.1 through monthly capitated rates (incorporating reinsurance provisions) per each Dual Eligible Member enrolled with MAO for integrated goods and services provided hereunder, including integrated behavioral health services, under this Agreement as per the terms and requirements of, each as applicable by program:  Contract Year Ending 2020 AHCCCS Complete Care (ACC) Program Capitation Rates xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/acc/A CCRatesEffectiveOctober12019.pdf  Contract Year Ending 2020 DD Program Capitation Rates DD contract, as amended xxxxx://xxx.xx.xxx/page.aspx/en/ctr/contract_manage_public/  Contract Year Ending 2020 RBHA Health Plan Capitation Rates xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RBHA /CYE2020RBHARateEffectiveOct12019.pdf Note: These above referenced capitation rates by AHCCCS health coverage program are subject to change as circumstances warrant. Any capitation rate updates by AHCCCS health coverage program are available at xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/RatesAndBilling/ManagedCare/cap itationrates.html.  AHCCCS Capitation Risk Pool to Eligibility Category to Rate Code Matrix xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RiskP ooltoEligibilityCategorytoRateCode.pdf  Contract Year Ending 2020 AHCCCS Complete Care (ACC) Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/acc/C YE20ACCCapitationRateCertificationSOF.pdf  Contract Year Ending 2020 ALTCS DD Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/ALTCS -DDD/CYE20ALTCSDDDCapitationRateCertificationSOF.pdf  Contract Year Ending 2020 RBHA Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RBHA /CYE20RBHACapitationRateCertificationSOF.pdf

Payment of Direct Capitation for Coverage of Integrated Medicaid Benefits. (HIDE): AHCCCS reimburses the MAO’s companion AHCCCS Complete Care (ACC), ALTCS DD, or ACC-RBHA health plan as structured per subparagraph 2.12.1 through monthly capitated rates (incorporating reinsurance provisions) per each enrolled Full Benefit Dual Eligible Member enrolled with MAO for integrated goods and services provided hereunder, including integrated behavioral health services, under this Agreement as per the terms and requirements of, each as applicable by program:  • Contract Year Ending 2020 2022 AHCCCS Complete Care (ACC) Program Capitation Rates xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/acc/A CCRatesEffectiveOctober12019.pdf  CCRatesEffectiveOctober12021.pdf; • Contract Year Ending 2020 2022 DD Program Capitation Rates DD contract, as amended xxxxx://xxx.xx.xxx/page.aspx/en/ctr/contract_manage_public/  contract CTR-047021 xxxxx://xxx.xx.xxx/page.aspx/en/ctr/contract manage public/47021; • Contract Year Ending 2020 2023 ACC-RBHA Health Plan Capitation Rates xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RBHA /CYE2020RBHARateEffectiveOct12019.pdf xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/HealthPlans/YH20- 0002 Procurement.html. Note: These above referenced capitation rates by AHCCCS health coverage program are subject to change as circumstances warrant. Any capitation rate updates by AHCCCS health coverage program are available at xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/RatesAndBilling/ManagedCare/cap itationrates.html.  • AHCCCS Capitation Risk Pool to Eligibility Category to Rate Code Matrix xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RiskP ooltoEligibilityCategorytoRateCode.pdf  ooltoEligibilityCategorytoRateCode.pdf; • Contract Year Ending 2020 2022 AHCCCS Complete Care (ACC) Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/acc/C YE20ACCCapitationRateCertificationSOF.pdf  YE 22 ACC Capitation Rate Certification SOF.pdf; • Contract Year Ending 2020 2022 ALTCS DD Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/ALTCS -DDD/CYE20ALTCSDDDCapitationRateCertificationSOF.pdf  CYE 22 ALTCS DDD Capitation Rate Certification SOF.pdf; • Contract Year Ending 2020 2023 ACC-RBHA Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RBHA /CYE20RBHACapitationRateCertificationSOF.pdfxxxxx://xxx.xxxxxxxx.xxx/PlansProviders/HealthPlans/YH20- 0002 Procurement.html.

Payment of Direct Capitation for Coverage of Integrated Medicaid Benefits. (HIDE): AHCCCS reimburses the MAO’s companion AHCCCS Complete Care (ACC), ALTCS DD, or RBHA health plan as structured per subparagraph 2.12.1 through monthly capitated rates (incorporating reinsurance provisions) per each Dual Eligible Member enrolled with MAO for integrated goods and services provided hereunder, including integrated behavioral health services, under this Agreement as per the terms and requirements of, each as applicable by program:  • Contract Year Ending 2020 AHCCCS Complete Care (ACC) Program Capitation Rates xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/acc/A CCRatesEffectiveOctober12019.pdf  • Contract Year Ending 2020 DD Program Capitation Rates DD contract, as amended xxxxx://xxx.xx.xxx/page.aspx/en/ctr/contract_manage_public/  • Contract Year Ending 2020 RBHA Health Plan Capitation Rates xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RBHA /CYE2020RBHARateEffectiveOct12019.pdf Note: These above referenced capitation rates by AHCCCS health coverage program are subject to change as circumstances warrant. Any capitation rate updates by AHCCCS health coverage program are available at xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/RatesAndBilling/ManagedCare/cap itationrates.html.  • AHCCCS Capitation Risk Pool to Eligibility Category to Rate Code Matrix xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RiskP ooltoEligibilityCategorytoRateCode.pdf  • Contract Year Ending 2020 AHCCCS Complete Care (ACC) Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/acc/C YE20ACCCapitationRateCertificationSOF.pdf  • Contract Year Ending 2020 ALTCS DD Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/ALTCS -DDD/CYE20ALTCSDDDCapitationRateCertificationSOF.pdf  • Contract Year Ending 2020 RBHA Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RBHA /CYE20RBHACapitationRateCertificationSOF.pdf

Payment of Direct Capitation for Coverage of Integrated Medicaid Benefits. (HIDE): AHCCCS reimburses the MAO’s companion AHCCCS Complete Care (ACC), ALTCS DD, or RBHA health plan as structured per subparagraph 2.12.1 through monthly capitated rates (incorporating reinsurance provisions) per each Dual Eligible Member enrolled with MAO for integrated goods and services provided hereunder, including integrated behavioral health services, under this Agreement as per the terms and requirements of, each as applicable by program:  Contract Year Ending 2020 AHCCCS Complete Care (ACC) Program Capitation Rates xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/acc/A CCRatesEffectiveOctober12019.pdf  Contract Year Ending 2020 DD Program Capitation Rates DD contract, as amended xxxxx://xxx.xx.xxx/page.aspx/en/ctr/contract_manage_public/  Contract Year Ending 2020 RBHA Health Plan Capitation Rates xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RBHA /CYE2020RBHARateEffectiveOct12019.pdf Note: These above referenced capitation rates by AHCCCS health coverage program are subject to change as circumstances warrant. Any capitation rate updates by AHCCCS health coverage program are available at xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/RatesAndBilling/ManagedCare/cap itationrates.html.  AHCCCS Capitation Risk Pool to Eligibility Category to Rate Code Matrix xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RiskP ooltoEligibilityCategorytoRateCode.pdf xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RiskPo oltoEligibilityCategorytoRateCode.pdf  Contract Year Ending 2020 AHCCCS Complete Care (ACC) Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/acc/C YE20ACCCapitationRateCertificationSOF.pdf  Contract Year Ending 2020 ALTCS DD Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/ALTCS -DDD/CYE20ALTCSDDDCapitationRateCertificationSOF.pdf  Contract Year Ending 2020 RBHA Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RBHA /CYE20RBHACapitationRateCertificationSOF.pdf

Payment of Direct Capitation for Coverage of Integrated Medicaid Benefits. (HIDE): AHCCCS reimburses the MAO’s companion AHCCCS Complete Care (ACC), ALTCS DD, or ACC-RBHA health plan as structured per subparagraph 2.12.1 through monthly capitated rates (incorporating reinsurance provisions) per each enrolled Full Benefit Dual Eligible Member enrolled with MAO for integrated goods and services provided hereunder, including integrated behavioral health services, under this Agreement as per the terms and requirements of, each as applicable by program:  • Contract Year Ending 2020 2022 AHCCCS Complete Care (ACC) Program Capitation Rates xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/acc/A CCRatesEffectiveOctober12019.pdf  CCRatesEffectiveOctober12021.pdf; • Contract Year Ending 2020 2022 DD Program Capitation Rates DD contract, as amended xxxxx://xxx.xx.xxx/page.aspx/en/ctr/contract_manage_public/  contract xxxxx://xxx.xx.xxx/page.aspx/en/ctr/contract manage public/; • Contract Year Ending 2020 2023 ACC-RBHA Health Plan Capitation Rates xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RBHA /CYE2020RBHARateEffectiveOct12019.pdf xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/HealthPlans/YH20- 0002 Procurement.html. Note: These above referenced capitation rates by AHCCCS health coverage program are subject to change as circumstances warrant. Any capitation rate updates by AHCCCS health coverage program are available at xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/RatesAndBilling/ManagedCare/cap itationrates.html.  • AHCCCS Capitation Risk Pool to Eligibility Category to Rate Code Matrix xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RiskP ooltoEligibilityCategorytoRateCode.pdf  ooltoEligibilityCategorytoRateCode.pdf; • Contract Year Ending 2020 2022 AHCCCS Complete Care (ACC) Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/acc/C YE20ACCCapitationRateCertificationSOF.pdf  YE 22 ACC Capitation Rate Certification SOF.pdf; • Contract Year Ending 2020 2022 ALTCS DD Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/ALTCS -DDD/CYE20ALTCSDDDCapitationRateCertificationSOF.pdf  CYE 22 ALTCS DDD Capitation Rate Certification SOF.pdf; • Contract Year Ending 2020 2023 ACC-RBHA Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RBHA /CYE20RBHACapitationRateCertificationSOF.pdfxxxxx://xxx.xxxxxxxx.xxx/PlansProviders/HealthPlans/YH20- 0002 Procurement.html.

Payment of Direct Capitation for Coverage of Integrated Medicaid Benefits. (HIDEFIDE): AHCCCS reimburses agrees to pay MAO (as per and to this Agreement’s “Participant” representing the MAO’s companion AHCCCS Complete Care (ACC), ALTCS DD, or RBHA health plan as structured per subparagraph 2.12.1 through sole Arizona corporate legal entity [corporation] under common direction and control) monthly capitated rates per each enrolled ALTCS E-PD Full Benefit Dual Eligible Member, and calculated as full compensation (incorporating reinsurance provisions) per each Dual Eligible Member enrolled with MAO for ALTCS Health Plan integrated goods and services provided hereunder, including integrated behavioral health servicesMedicaid managed long- term supports and services (MLTSS), in that month under this Agreement as per the terms and requirements of, each as applicable by programper:  • Contract Year Ending 2020 AHCCCS Complete Care (ACC) 2022 ALTCS E-PD Program Capitation Rates xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/acc/A CCRatesEffectiveOctober12019.pdf  Contract Year Ending 2020 DD Program Capitation Rates DD contract, as amended xxxxx://xxx.xx.xxx/page.aspx/en/ctr/contract_manage_public/  Contract Year Ending 2020 RBHA Health Plan Capitation Rates xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RBHA /CYE2020RBHARateEffectiveOct12019.pdf Note: These above referenced capitation rates by AHCCCS health coverage program are subject to change as circumstances warrant. Any capitation rate updates by AHCCCS health coverage program are available at xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/RatesAndBilling/ManagedCare/cap itationrates.html.  xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/ALTC S/ALTCSEPDRatesEffectiveOct12021.pdf; • AHCCCS Capitation Risk Pool to Eligibility Category to Rate Code Matrix xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RiskP ooltoEligibilityCategorytoRateCode.pdf  ooltoEligibilityCategorytoRateCode.pdf; • Contract Year Ending 2020 AHCCCS Complete Care (ACC) 2022 ALTCS E-PD Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/acc/C YE20ACCCapitationRateCertificationSOF.pdf  Contract Year Ending 2020 xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/ALTC S/CYE22ALTCSEPDCapitationRateCertificationSOF.pdf. Note: This annual ALTCS DD Program E-PD Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/ALTCS -DDD/CYE20ALTCSDDDCapitationRateCertificationSOF.pdf  Contract Year Ending 2020 RBHA Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RBHA /CYE20RBHACapitationRateCertificationSOF.pdfincludes all specific and usual and customary Medicaid covered service reimbursement requirements and adjustments by specific rate cell and capitation rate. Such components include, but are not limited to: institutional and MLTSS eligibility, institutional and MLTSS covered services, demographic characteristics, etc. Specific rate cell categories are assigned prospectively based on eligibility for the next available month. For FIDE SNP status purposes under this Agreement, there are no carved out AHCCCS covered services.

Payment of Direct Capitation for Coverage of Integrated Medicaid Benefits. (HIDE): AHCCCS reimburses the MAO’s companion AHCCCS Complete Care (ACC), ALTCS DD, or ACC-RBHA health plan as structured per subparagraph 2.12.1 through monthly capitated rates (incorporating reinsurance provisions) per each enrolled Full Benefit Dual Eligible Member enrolled with MAO for integrated goods and services provided hereunder, including integrated behavioral health services, under this Agreement as per the terms and requirements of, each as applicable by program:  • Contract Year Ending 2020 2022 AHCCCS Complete Care (ACC) Program Capitation Rates xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/acc/A CCRatesEffectiveOctober12019.pdf  CCRatesEffectiveOctober12021.pdf; • Contract Year Ending 2020 2022 DD Program Capitation Rates DD contract, as amended xxxxx://xxx.xx.xxx/page.aspx/en/ctr/contract_manage_public/  contract CTR-047021 xxxxx://xxx.xx.xxx/page.aspx/en/ctr/contract_manage_public/47021; • Contract Year Ending 2020 2023 ACC-RBHA Health Plan Capitation Rates xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RBHA /CYE2020RBHARateEffectiveOct12019.pdf xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/HealthPlans/YH20- 0002_Procurement.html. Note: These above referenced capitation rates by AHCCCS health coverage program are subject to change as circumstances warrant. Any capitation rate updates by AHCCCS health coverage program are available at xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/RatesAndBilling/ManagedCare/cap itationrates.html.  MEDICARE ADVANTAGE ORGANIZATION AGREEMENT BETWEEN AHCCCS AND Participant Health Choice Arizona, Inc. d/b/a Health Choice Pathway AHCCCS AGREEMENT # YH23-0010-03 • AHCCCS Capitation Risk Pool to Eligibility Category to Rate Code Matrix xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RiskP ooltoEligibilityCategorytoRateCode.pdf  ooltoEligibilityCategorytoRateCode.pdf; • Contract Year Ending 2020 2022 AHCCCS Complete Care (ACC) Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/acc/C YE20ACCCapitationRateCertificationSOF.pdf  YE_22_ACC_Capitation_Rate_Certification_SOF.pdf; • Contract Year Ending 2020 2022 ALTCS DD Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/ALTCS -DDD/CYE20ALTCSDDDCapitationRateCertificationSOF.pdf  CYE_22_ALTCS_DDD_Capitation_Rate_Certification_SOF.pdf; • Contract Year Ending 2020 2023 ACC-RBHA Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RBHA /CYE20RBHACapitationRateCertificationSOF.pdfxxxxx://xxx.xxxxxxxx.xxx/PlansProviders/HealthPlans/YH20- 0002_Procurement.html.

Payment of Direct Capitation for Coverage of Integrated Medicaid Benefits. (HIDE): AHCCCS reimburses the MAO’s companion AHCCCS Complete Care (ACC), ALTCS DD, or ACC-RBHA health plan as structured per subparagraph 2.12.1 through monthly capitated rates (incorporating reinsurance provisions) per each enrolled Full Benefit Dual Eligible Member enrolled with MAO for integrated goods and services provided hereunder, including integrated behavioral health services, under this Agreement as per the terms and requirements of, each as applicable by program:  Contract Year Ending 2020 2022 AHCCCS Complete Care (ACC) Program Capitation Rates xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/acc/A CCRatesEffectiveOctober12019.pdf  CCRatesEffectiveOctober12021.pdf; Contract Year Ending 2020 2022 DD Program Capitation Rates DD contract, as amended xxxxx://xxx.xx.xxx/page.aspx/en/ctr/contract_manage_public/  contract xxxxx://xxx.xx.xxx/page.aspx/en/ctr/contract manage public/; Contract Year Ending 2020 2023 ACC-RBHA Health Plan Capitation Rates xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RBHA /CYE2020RBHARateEffectiveOct12019.pdf xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/HealthPlans/YH20- 0002 Procurement.html. Note: These above referenced capitation rates by AHCCCS health coverage program are subject to change as circumstances warrant. Any capitation rate updates by AHCCCS health coverage program are available at xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/RatesAndBilling/ManagedCare/cap itationrates.html.  AHCCCS Capitation Risk Pool to Eligibility Category to Rate Code Matrix xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RiskP ooltoEligibilityCategorytoRateCode.pdf  ooltoEligibilityCategorytoRateCode.pdf; Contract Year Ending 2020 2022 AHCCCS Complete Care (ACC) Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/acc/C YE20ACCCapitationRateCertificationSOF.pdf  YE 22 ACC Capitation Rate Certification SOF.pdf; Contract Year Ending 2020 2022 ALTCS DD Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/ALTCS -DDD/CYE20ALTCSDDDCapitationRateCertificationSOF.pdf  CYE 22 ALTCS DDD Capitation Rate Certification SOF.pdf; Contract Year Ending 2020 2023 ACC-RBHA Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RBHA /CYE20RBHACapitationRateCertificationSOF.pdfxxxxx://xxx.xxxxxxxx.xxx/PlansProviders/HealthPlans/YH20- 0002 Procurement.html.

Payment of Direct Capitation for Coverage of Integrated Medicaid Benefits. (HIDE): AHCCCS reimburses the MAO’s companion AHCCCS Complete Care (ACC), ALTCS DD, or RBHA health plan as structured per subparagraph 2.12.1 through monthly capitated rates (incorporating reinsurance provisions) per each Dual Eligible Member enrolled with MAO for integrated goods and services provided hereunder, including integrated behavioral health services, under this Agreement as per the terms and requirements of, each as applicable by program:  Contract Year Ending 2020 AHCCCS Complete Care (ACC) Program Capitation Rates xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/acc/A CCRatesEffectiveOctober12019.pdf  Contract Year Ending 2020 DD Program Capitation Rates DD contractcontract CTR-047021, as amended xxxxx://xxx.xx.xxx/page.aspx/en/ctr/contract_manage_public/ xxxxx://xxx.xx.xxx/page.aspx/en/ctr/contract_manage_public/47021;  Contract Year Ending 2020 RBHA Health Plan Capitation Rates xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RBHA /CYE2020RBHARateEffectiveOct12019.pdf Note: These above referenced capitation rates by AHCCCS health coverage program are subject to change as circumstances warrant. Any capitation rate updates by AHCCCS health coverage program are available at xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/RatesAndBilling/ManagedCare/cap itationrates.html.  AHCCCS Capitation Risk Pool to Eligibility Category to Rate Code Matrix xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RiskP ooltoEligibilityCategorytoRateCode.pdf  Contract Year Ending 2020 AHCCCS Complete Care (ACC) Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/acc/C YE20ACCCapitationRateCertificationSOF.pdf  Contract Year Ending 2020 ALTCS DD Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/ALTCS -DDD/CYE20ALTCSDDDCapitationRateCertificationSOF.pdf  Contract Year Ending 2020 RBHA Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RBHA /CYE20RBHACapitationRateCertificationSOF.pdf

Payment of Direct Capitation for Coverage of Integrated Medicaid Benefits. (HIDE): AHCCCS reimburses the MAO’s companion AHCCCS Complete Care (ACC), ALTCS DD, or ACC-RBHA health plan as structured per subparagraph 2.12.1 through monthly capitated rates (incorporating reinsurance provisions) per each enrolled Full Benefit Dual Eligible Member enrolled with MAO for integrated goods and services provided hereunder, including integrated behavioral health services, under this Agreement as per the terms and requirements of, each as applicable by program:  • Contract Year Ending 2020 2022 AHCCCS Complete Care (ACC) Program Capitation Rates xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/acc/A CCRatesEffectiveOctober12019.pdf  CCRatesEffectiveOctober12021.pdf; • Contract Year Ending 2020 2022 DD Program Capitation Rates DD contract, as amended xxxxx://xxx.xx.xxx/page.aspx/en/ctr/contract_manage_public/  contract CTR-047021 xxxxx://xxx.xx.xxx/page.aspx/en/ctr/contract_manage_public/47021; • Contract Year Ending 2020 2023 ACC-RBHA Health Plan Capitation Rates xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RBHA /CYE2020RBHARateEffectiveOct12019.pdf xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/HealthPlans/YH20- 0002_Procurement.html. Note: These above referenced capitation rates by AHCCCS health coverage program are subject to change as circumstances warrant. Any capitation rate updates by AHCCCS health coverage program are available at xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/RatesAndBilling/ManagedCare/cap itationrates.html.  • AHCCCS Capitation Risk Pool to Eligibility Category to Rate Code Matrix xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RiskP ooltoEligibilityCategorytoRateCode.pdf  ooltoEligibilityCategorytoRateCode.pdf; • Contract Year Ending 2020 2022 AHCCCS Complete Care (ACC) Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/acc/C YE20ACCCapitationRateCertificationSOF.pdf  YE_22_ACC_Capitation_Rate_Certification_SOF.pdf; • Contract Year Ending 2020 2022 ALTCS DD Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/ALTCS -DDD/CYE20ALTCSDDDCapitationRateCertificationSOF.pdf  CYE_22_ALTCS_DDD_Capitation_Rate_Certification_SOF.pdf; • Contract Year Ending 2020 2023 ACC-RBHA Program Capitation Rate Certification xxxxx://xxx.xxxxxxxx.xxx/PlansProviders/Downloads/CapitationRates/RBHA /CYE20RBHACapitationRateCertificationSOF.pdfxxxxx://xxx.xxxxxxxx.xxx/PlansProviders/HealthPlans/YH20- 0002_Procurement.html.