AHCA CONTRACT NO. FA522 AMENDMENT NO. 2
Exhibit 10.1
WELL CARE HMO, INC. | Medicaid HMO Contract | |
d/b/a STAYWELL HEALTH PLAN OF FLORIDA |
AHCA CONTRACT NO. FA522
AMENDMENT NO. 2
THIS CONTRACT, entered into between STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, hereinafter referred to as the “Agency” and WELL CARE HMO, INC., d/b/a STAYWELL HEALTH PLAN OF FLORIDA, hereinafter referred to as the “Vendor”, is hereby amended as follows:
1. | Standard Contract, the first paragraph is hereby amended to change the Vendor’s address to the following: |
0000 Xxxxxxxxx Xxxx, Xxx 0
Xxxxx, XX 00000
2. | Standard Contract, Section III.C.2 is hereby amended to change the contract manager’s name, address and telephone number to the following: |
Xxxxx Xxxxxxxxx
Well Care HMO, Inc., d/b/a Staywell Health Plan of Florida
0000 Xxxxxxxxx Xxxx, Xxx 0
Xxxxx, XX 00000
(000) 000-0000
3. | Standard Contract, Section III.E.1 is hereby amended to change the mailing address to the following: |
Well Care HMO, Inc., d/b/a Staywell Health Plan of Florida
Attn: Regulatory Affairs
X.X. Xxx 00000
Xxxxx, XX 00000-0000
4. | Standard Contract, Section III.E.2 is hereby amended to change the contact person and street address to the following: |
Xxxxx Xxxxxxxxx
0000 Xxxxxxxxx Xxxx, Xxx 0
Xxxxx, XX 00000
5. | This amendment shall begin on December 3, 2004, or the date on which the amendment has been signed by both parties, whichever is later. |
All provisions in the Contract and any attachments thereto in conflict with this amendment shall be and are hereby changed to confirm 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.
AHCA Contract No. FA522, Amendment No. 2, Page 1 of 3
WELL CARE HMO, INC. | Medicaid HMO Contract | |
d/b/a STAYWELL HEALTH PLAN OF FLORIDA |
This amendment and all its attachments are hereby made a part of the Contract.
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 2 page amendment (including all attachments) to be executed by their officials thereunto duly authorized.
WELL CARE HMO, INC., d/b/a STAYWELL HEALTH PLAN OF FLORIDA |
STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION | |||||
SIGNED | SIGNED | |||||
BY: | /s/ XXXX X. XXXXX |
BY: | /s/ XXXX XXXXXX | |||
NAME: | Xxxx X. Xxxxx | NAME: | Xxxx Xxxxxx | |||
TITLE: | Chief Executive Officer | TITLE: | Secretary | |||
DATE:12/27/04 | DATE:1/14/05 |
THE REMAINDER OF THIS PAGE LEFT BLANK INTENTIONALLY
AHCA Contract No. FA522, Amendment No. 2, Page 2 of 3