AHCA CONTRACT NO. FA904 AMENDMENT NO. 1
Exhibit
10.57.1
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WellCare
of Florida, Inc.
d/b/a
Staywell Health Plan of Florida
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Medicaid
HMO Non-Reform Contract
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AHCA
CONTRACT NO. FA904
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AMENDMENT
NO. 1
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THIS CONTRACT, entered into
between the STATE OF FLORIDA,
AGENCY FOR HEALTH CARE
ADMINISTRATION, hereinafter referred to as the "Agency" and WELLCARE OF FLORIDA, INC. D/B/A STAYWELL HEALTH PLAN OF
FLORIDA, hereinafter referred to as the "Vendor" or the "Health Plan", is hereby
amended as follows:
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1.
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Effective
January 1, 2010, Attachment I, Scope of Services, Capitated Health Plans,
Section D., Service(s) to be Provided, Item 2., Approved Expanded
Benefits, sub-item a., is hereby amended to include Table 6-A, Revised
Expanded Services, as follows. All references in the Contract to Table 6,
Expanded Services, shall hereinafter also refer to Table 6-A, as
appropriate.
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TABLE
6-A
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Revised
Expanded Services
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Effective
January 1, 2010
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None
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| 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 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 one (1) page amendment (which includes all
attachments hereto) to be executed by their officials thereunto duly
authorized.
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WELLCARE
OF FLORIDA, INC. D/B/A
STAYWELL
HEALTH PLAN OF FLORIDA
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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 &
CEO
Date:
_________________________
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SIGNED
BY:
/s/ Xxxxxx X.
Xxxxxx
Name:
Xxxxxx X.
Xxxxxx
Title:
Secretary
Date:11/12/09
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REMAINDER
OF PAGE INTENTIONALLY LEFT BLANK
AHCA
Contract No. FA904, Amendment No. 1, Page 1 of
1
