AHCA CONTRACT NO. FA619 AMENDMENT NO. 9
Exhibit 10.2
| HealthEase of Florida, Inc. |
AHCA
CONTRACT NO. FA619
AMENDMENT
NO. 9
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., hereinafter referred to as the “Vendor” or “Health Plan”,
is hereby amended as follows:
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1.
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Attachment
II, Medicaid Prepaid Health Plan Model Contract, Section X.,
Administration and Management, Item I., Fraud Prevention, sub-item 4., is
hereby amended to include the
following:
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I.
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Provide
details about the following, as required by Section 6032 of the federal
Deficit Reduction Act of 2005:
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(1)
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the
False Claim Act;
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(2)
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the
penalties for submitting false claims and
statements;
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(3)
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whistleblower
protections;
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(4)
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the
law’s role in preventing and detecting fraud, waste and abuse;
and,
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(5)
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each
person’s responsibility relating to detection and
prevention.
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2.
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Attachment
II, Medicaid Prepaid Health Plan Model Contract, Section X.,
Administration and Management, Item I., sub-item 7. is hereby included as
follows:
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7.
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In
accordance with Section 6032 of the federal Deficit Reduction Act of 2005,
the Health Plan shall distribute written Fraud and Abuse policies to all
employees. If the Health Plan has an employee handbook, the
Health Plan shall include specific information about Section 6032 of the
federal Deficit Reduction Act of 2005, the Health Plan’s policies, and the
rights of employees to be protected as
whistleblowers.
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3.
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Attachment
II, Medicaid Prepaid Health Plan Model Contract, Section XVI., Terms and
Conditions, Item 0., Subcontracts, sub-items 9. and 10., are hereby
included as follows:
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9.
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The
Health Plan must provide that compensation to individuals or entities that
conduct utilization management activities is not structured so as to
provide incentives for the individual or entity to deny, limit, or
discontinue medically necessary services to any
Enrollee.
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10.
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Provide
details about the following, as required by Section 6032 of the federal
Deficit Reduction Act of 2005:
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(6)
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the
False Claim Act;
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(7)
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the
penalties for submitting false claims and
statements;
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(8)
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whistleblower
protections;
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(9)
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the
law’s role in preventing and detecting fraud, waste and abuse;
and,
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(10)
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each
person’s responsibility relating to detection and
prevention.
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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 part of the
Contract.
AHCA
Contract No. FA619, Amendment No. 9, Page of 1 of
2
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 two (2) page Amendment
(including all attachments) to be executed by their officials thereunto duly
authorized.
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HEALTHEASE
OF FLORIDA, INC
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STATE
OF FLORIDA, AGENCY FOR
HEALTH
CARE ADMINISTRATION
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SIGNED
BY: /s/
Xxxxx
Xxxxxxxxx
NAME: Xxxxx
Xxxxxxxxx
TITLE: President
and CEO
DATE: June
29, 2009
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SIGNED
BY: /s/
Xxxxx
Xxxxxx
NAME: Xxxxx
Xxxxxx
TITLE: Secretary
DATE: 6/30/09
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REMAINDER
OF PAGE INTENTIONALLY LEFT BLANK
AHCA
Contract No. FA619, Amendment No. 9, Page of 2 of
2
