AHCA CONTRACT NO. FAR005 AMENDMENT NO. 5
Exhibit 10.27.2.2
Amerigroup Florida, Inc. d/b/a Amerigroup Community Care |
Medicaid HMO Contract |
AHCA CONTRACT NO. FAR005
AMENDMENT NO. 5
AMENDMENT NO. 5
THIS CONTRACT, entered into between the STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,
hereinafter referred to as the “Agency” and AMERIGROUP FLORIDA, INC. D/B/A AMERIGROUP COMMUNITY
CARE, hereinafter referred to as the “Vendor” or “Health Plan”, is hereby amended as follows:
1. Effective September 1, 2007, Attachment I, Scope of Services, is hereby amended to include
Exhibit 5-B, attached hereto and made a part of the Contract. All references in the Contract to
Exhibit 5-A, shall hereinafter instead refer to Exhibit 5-B.
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 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 two (2) page Amendment (which includes
all attachments hereto) to be executed by their officials thereunto duly authorized.
AMERIGROUP FLORIDA, INC. D/B/A/ AMERIGROUP COMMUNITY CARE |
STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION |
||||||
SIGNED
|
SIGNED | ||||||
BY: |
/S/ Xxxxxxx XxXxxx | BY: | |||||
NAME: |
Xxxxxxx XxXxxx | NAME: | Xxxxxx X. Xxxxxxxx, M.D | ||||
TITLE: |
CEO | TITLE: | Secretary | ||||
DATE:
|
11-30-07 | DATE: |
List of attachments included as part of this Amendment:
Specify | Letter/ | |||
Type | Number | Description | ||
Exhibit
|
5-B | Capitation Rates SSI Medicare Part B Only and SSI Medicare Parts A and B Enrollees for All Medicaid Reform Counties (1 Page) |
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AHCA Contract No. FAR005, Amendment No. 5, Page 1 of 1
EXHIBIT 5 — B
CAPTITATION RATES
SSI MEDICARE PART B ONLY
AND
SSI MEDICARE PARTS A AND B ENROLLEES
FOR ALL MEDICAID REFORM COUNTIES
CAPTITATION RATES
SSI MEDICARE PART B ONLY
AND
SSI MEDICARE PARTS A AND B ENROLLEES
FOR ALL MEDICAID REFORM COUNTIES
Table 4
***REDACTED***
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AHCA Contract No. FAR005, Exhibit 5-B, Page 1 of 1