AMENDMENT #2 TO CONTRACT NO. 0654 BETWEEN GEORGIA DEPARTMENT OF COMMUNITY HEALTH AND WELLCARE OF GEORGIA, INC.
Exhibit
10.2
AMENDMENT
#2 TO CONTRACT NO. 0654 BETWEEN
GEORGIA
DEPARTMENT OF COMMUNITY HEALTH AND
WELLCARE
OF GEORGIA, INC.
This
Amendment is between the Georgia Department of Community Health (hereinafter
referred to as "DCH" or the "Department") and WellCare of Georgia, Inc.
(hereinafter referred to as
"Contractor") and is made effective this 28th
day of
January, 2008 (hereinafter referred to as the "Effective
Date"). Other than the changes, modifications and additions
specifically articulated in this Amendment #2 to Contract # 0654,
RFP#00000-000-0000000000, the original Contract shall remain in effect
and
binding on and against DCH and Contractor. Unless expressly modified or
added in
this Amendment #2, the terms and conditions of the original Contract are
expressly incorporated into this Amendment #2 as if completely restated
herein.
WHEREAS,
DCH
and Contractor
executed a contract for the provision of services to Georgia Healthy Families;
and,
WHEREAS,
pursuant
to Section 4.8.17.1, Network
Changes,
DCH and Contractor have agreed that Contractor shall notify DCH
within
seven (7) Business Days of any significant changes to the Provider network
or,
if applicable, to any Subcontractor's Provider Network; and,
WHEREAS,
pursuant
to Section 32.0, Amendments
in
Writing, DCH and Contractor desire to amend the above-referenced Contract
by adding additional funding as set forth below.
NOW
THEREFORE, for and in
consideration of the mutual promises of the Parties, the terms, provisions
and
conditions of this Amendment and other good and valuable consideration,
the
sufficiency of which is hereby acknowledged, DCH and Contractor hereby
agree as
follows:
I. To
delete
the current Attachment II,
Capitation
Payment, in its entirety and replace with the new Attachment H,
Capitation
Payment, contained at Exhibit 1 to this Amendment.
II. To
amend
the Contract by adding Section
4.8.17.6, which reads as follows:
|
4.8.17.6
|
If
the Contractor fails to comply with the provisions of Section
4.8.17.1,
the per member per month capitation rate, used by DCH to compensate
the
Contractor, will be reduced by 3.1% for the remaining term of
the
Contract, including any renewals.
|
Amendment
#2
Contract
#0654
Page
1 of
6
III.
To amend the Contract by adding Section 4.8.17.7, which reads
as follows:
|
4.8.17.7
|
DCH
and Contractor acknowledge that any failure by Contractor to
comply with
the terms of Section 4.8.17.1 would constitute a material failure
to
implement the terms of the Contract and RFP. If liquidated damages
are
assessed against the Contractor due to its failure to comply
with Section
4.8.17.1, the damages will be assessed in accordance with Section
23.2.1
(Category 1).
|
IV. DCH
and
Contractor agree that they have assumed an obligation to perform the covenants,
agreements, duties and obligations of the Contract, as modified and amended
herein, and agree to abide by all the provisions, terms and conditions
contained
in the Contract as modified and amended.
V.
This
Amendment shall be binding and inure to the benefit of the parties hereto,
their
heirs, representatives, successors and assigns. Whenever the provisions
of this
Amendment and the Contract are in conflict, the provisions of this Amendment
shall take precedence and control.
VI. It
is
understood by the Parties hereto that, if any part, term, or provision
of this
Amendment or this entire Amendment is held to be illegal or in conflict
with any
law of this State, then DCH, at its sole option, may enforce the remaining
unaffected portions or provisions of this Amendment or of the Contract
and the
rights and obligations of the parties shall be construed and enforced as
if the
Contract or Amendment did not contain the particular part, term or provision
held to be invalid.
VII. This
Amendment shall become effective as stated herein and shall remain effective
for
so long as the Contract is in effect.
VIII. This
Amendment shall be construed in accordance with the laws of the State of
Georgia.
IX. All
other
terms and conditions contained in the Contract and any amendment thereto,
not
amended by this Amendment, shall remain in full force and
effect.
- SIGNATURES
ON THE FOLLOWING
PAGE -
Amendment
#2
Contract
#0654
Page
2 of
6
IN
WITNESS WHEREOF, DCH and
Contractor, through their authorized officers and agents, have caused this
Amendment to be executed on their behalf as of the date
indicated.
|
GEORGIA
DEPARTMENT OF COMMUNITY HEALTH
|
|
|
/s/
XXXXXX
X. XXXXXX
|
January
28,
2008
|
|
Xx.
Xxxxxx X. Xxxxxx, M.D.
|
Date
|
|
Commissioner
|
|
|
WELLCARE
OF GEORGIA, INC.
|
|
|
/s/ XXXX
X.
XXXXX
|
November
16,
2007
|
|
*
Signature
Xxxx
X.
Xxxxx
Please
Print/Type Name Here
|
SEAL
AFFIX
CORPORATE SEAL HERE
(Corporations
without a seal, attach
a
Certificate of Corporate Resolution)
|
ATTEST: /s/ XXXXXXXX
XXXXXXX
|
|
|
**Signature
|
|
|
Secretary
|
|
|
TITLE
|
*
Must be
President, Vice President, CEO or Other Authorized Officer
**Must
be
Corporate Secretary
Amendment
#2
Contract
#0654
Page
3 of
6
CONFIDENTIAL
- NOT FOR CIRCULATION
ATTACHMENT
H
Attachment
H is a table displaying the contracted rates by rate cell for each contracted
region. These rates will be the basis for calculating capitation payments
in
each contracted Region.
(The
table is displayed on the following page.)
Amendment
#2
Contract
#0654
Page
4 of
6
Georgia
Department of Community Health
Fiscal
Year 2008 CMO Rates
| WellCare | WellCare | |||
|
QA
Fee:
|
6.00%
|
5.50%
|
||
|
July
- Dec
2007
|
Jan
-
Jun
2008
|
|||
|
Region
|
Aid
Category
|
Age/Gender
Group
|
||
|
Atlanta
|
Medicaid
(LIM/Refugee/RSM)
|
0
-
2 Months, Male and Female
|
1,686.95
|
1,678.99
|
|
Medicaid
(LIM/Refugee/RSM)
|
3-11
Months, Male and Female
|
175.88
|
175.05
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
1
-
5 Years, Male and Female
|
119.24
|
118.68
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
6
-
13 Years, Male and Female
|
107.85
|
107.34
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
14-20
Years, Female
|
172.10
|
171.28
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
14-20
Years, Male
|
126.45
|
125.85
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
21
- 44 Years, Female
|
249.62
|
248.45
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
21
-44 Years, Male
|
252.83
|
251.63
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
45+
Years, Female
|
438.16
|
436.10
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
45+
Years, Male
|
440.12
|
438.04
|
|
|
PeachCare
|
0
-
2 Months, Male and Female
|
179.39
|
178.55
|
|
|
PeachCare
|
3-11
Months, Male and Female
|
179.39
|
178.55
|
|
|
PeachCare
|
1
-
5 Years, Male and Female
|
104.48
|
103.98
|
|
|
PeachCare
|
6
-
13 Years, Male and Female
|
108.68
|
108.17
|
|
|
PeachCare
|
14
- 20 Years, Female
|
127.11
|
126.51
|
|
|
PeachCare
|
14-20
Years, Male
|
119.01
|
118.45
|
|
|
Breast
and Cervical Cancer
|
All
Ages
|
1,138.98
|
1,133.60
|
|
|
Maternity
Delivery/Kick Payment
|
6,777.77
|
6,745.80
|
||
|
Central
|
Medicaid
(LIM/Refugee/RSM)
|
0
-
2 Months, Male and Female
|
1,723.33
|
1,715.20
|
|
Medicaid
(LIM/Refugee/RSM)
|
3-11
Months, Male and Female
|
215.31
|
214.29
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
1
-
5 Years, Male and Female
|
127.66
|
127.06
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
6
-
13 Years, Male and Female
|
115.61
|
115.07
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
14-20
Years, Female
|
168.58
|
167.78
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
14-20
Years, Male
|
121.55
|
120.97
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
21
-44 Years, Female
|
274.58
|
273.29
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
21
- 44 Years, Male
|
310.79
|
309.33
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
45+
Years, Female
|
498.45
|
496.10
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
45+
Years, Male
|
604.05
|
601.21
|
|
|
PeachCare
|
0
-
2 Months, Male and Female
|
183.03
|
182.16
|
|
|
PeachCare
|
3-11
Months, Male and Female
|
183.03
|
182.16
|
|
|
PeachCare
|
1
-
5 Years, Male and Female
|
120.36
|
119.79
|
|
|
PeachCare
|
6
-
13 Years, Male and Female
|
119.69
|
119.13
|
|
|
PeachCare
|
14-20
Years, Female
|
148.84
|
148.14
|
|
|
PeachCare
|
14-20
Years, Male
|
124.72
|
124.14
|
|
|
Breast
and Cervical Cancer
|
All
Ages
|
1,161.84
|
1,156.36
|
|
|
Maternity
Delivery/Kick Payment
|
6,631.61
|
6,600.33
|
||
|
East
|
Medicaid
(LIM/Refugee/RSM)
|
0
-
2 Months, Male and Female
|
1,604.21
|
1,596.65
|
|
Medicaid
(LIM/Refugee/RSM)
|
3-11
Months, Male and Female
|
206.47
|
205.50
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
1
-
5 Years, Male and Female
|
134.69
|
134.05
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
6
-
13 Years, Male and Female
|
114.15
|
113.61
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
14-20
Years, Female
|
167.47
|
166.69
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
14-20
Years, Male
|
119.67
|
119.11
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
21
-44 Years, Female
|
271.23
|
269.95
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
21
-44 Years, Male
|
299.17
|
297.75
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
45+
Years, Female
|
476.03
|
473.78
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
45+
Years, Male
|
611.35
|
608.47
|
|
|
PeachCare
|
0-2
Months, Male and Female
|
183.03
|
182.16
|
|
|
PeachCare
|
3-11
Months, Male and Female
|
183.03
|
182.16
|
|
|
PeachCare
|
1
-
5 Years, Male and Female
|
123.30
|
122.72
|
|
|
PeachCare
|
6
-
13 Years, Male and Female
|
117.74
|
117.18
|
|
|
PeachCare
|
14-20
Years, Female
|
143.56
|
142.88
|
|
|
PeachCare
|
14-20
Years, Male
|
121.01
|
120.43
|
|
|
Breast
and Cervical Cancer
|
All
Ages
|
1,161.84
|
1,156.36
|
|
|
Maternity
Delivery/Kick Payment
|
6,702.49
|
6,670.87
|
11/1/2007,
2:21 PM
Georgia
Department of Community Health
Fiscal
Year 2008 CMO Rates
| WellCare | WellCare | |||
|
QA
Fee:
|
6.00%
|
5.50%
|
||
|
July
- Dec
2007
|
Jan
-
Jun
2008
|
|||
|
Region
|
Aid
Category
|
Age/Gender
Group
|
|
North
|
Medicaid
(LIM/Refugee/RSM)
|
0
-
2 Months, Male and Female
|
1,682.74
|
1,674.80
|
|
Medicaid
(LIM/Refugee/RSM)
|
3-11
Months, Male and Female
|
210.78
|
209.79
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
1
-
5 Years, Male and Female
|
139.70
|
139.04
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
6-13
Years, Male and Female
|
127.19
|
126.59
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
14-20
Years, Female
|
201.93
|
200.98
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
14-20
Years, Male
|
140.11
|
139.45
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
21
-44 Years, Female
|
317.82
|
316.32
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
21
-44 Years, Male
|
338.12
|
336.53
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
45+
Years, Female
|
514.19
|
511.76
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
45+
Years, Male
|
611.35
|
608.47
|
|
|
PeachCare
|
0
-
2 Months, Male and Female
|
183.03
|
182.16
|
|
|
PeachCare
|
3-11
Months, Male and Female
|
183.03
|
182.16
|
|
|
PeachCare
|
1
-
5 Years, Male and Female
|
119.96
|
119.40
|
|
|
PeachCare
|
6-13
Years, Male and Female
|
123.36
|
122.77
|
|
|
PeachCare
|
14-20
Years, Female
|
146.87
|
146.17
|
|
|
PeachCare
|
14-20
Years, Male
|
136.52
|
135.87
|
|
|
Breast
and Cervical Cancer
|
All
Ages
|
1,161.84
|
1,156.36
|
|
|
Maternity
Delivery/Kick Payment
|
6,631.92
|
6,600.63
|
||
|
Southeast
|
Medicaid
(LIM/Refugee/RSM)
|
0-2
Months, Male and Female
|
1,674.18
|
1,666.29
|
|
Medicaid
(LIM/Refugee/RSM)
|
3-11
Months, Male and Female
|
227.57
|
226.49
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
1
-
5 Years, Male and Female
|
135.55
|
134.91
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
6
-
13 Years, Male and Female
|
118.76
|
118.20
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
14-20
Years, Female
|
187.36
|
186.48
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
14-20
Years, Male
|
121.12
|
120.55
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
21
-44 Years, Female
|
308.16
|
306.70
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
21
-44 Years, Male
|
317.36
|
315.86
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
45+
Years, Female
|
532.84
|
530.33
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
45+
Years, Male
|
565.23
|
562.57
|
|
|
PeachCare
|
0-2
Months, Male and Female
|
183.74
|
182.87
|
|
|
PeachCare
|
3-11
Months, Male and Female
|
183.74
|
182.87
|
|
|
PeachCare
|
1
-
5 Years, Male and Female
|
125.56
|
124.97
|
|
|
PeachCare
|
6
-
13 Years, Male and Female
|
128.60
|
128.00
|
|
|
PeachCare
|
14-20
Years, Female
|
146.79
|
146.10
|
|
|
PeachCare
|
14-20
Years, Male
|
127.02
|
126.42
|
|
|
Breast
and Cervical Cancer
|
All
Ages
|
1,167.98
|
1,162.47
|
|
|
Maternity
Delivery/Kick Payment
|
6,955.47
|
6,922.67
|
||
|
Southwest
|
Medicaid
(LIM/Refugee/RSM)
|
0
-
2 Months, Male and Female
|
1,766.20
|
1,757.87
|
|
Medicaid
(LIM/Refugee/RSM)
|
3-11
Months, Male and Female
|
242.09
|
240.95
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
1
-
5 Years, Male and Female
|
145.16
|
144.48
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
6
-
13 Years, Male and Female
|
119.44
|
118.88
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
14-20
Years, Female
|
187.18
|
186.30
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
14-20
Years, Male
|
121.48
|
120.90
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
21
- 44 Years, Female
|
287.41
|
286.05
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
21
-44 Years, Male
|
287.79
|
286.44
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
45+
Years, Female
|
500.44
|
498.08
|
|
|
Medicaid
(LIM/Refugee/RSM)
|
45+
Years, Male
|
594.62
|
591.81
|
|
|
PeachCare
|
0
-
2 Months, Male and Female
|
183.74
|
182.87
|
|
|
PeachCare
|
3-11
Months, Male and Female
|
183.74
|
182.87
|
|
|
PeachCare
|
1-5
Years, Male and Female
|
129.04
|
128.43
|
|
|
PeachCare
|
6
-
13 Years, Male and Female
|
127.79
|
127.19
|
|
|
PeachCare
|
14-20
Years, Female
|
144.83
|
144.15
|
|
|
PeachCare
|
14-20
Years, Male
|
127.16
|
126.56
|
|
|
Breast
and Cervical Cancer
|
All
Ages
|
1,167.98
|
1,162.47
|
|
|
Maternity
Delivery/Kick Payment
|
6,679.51
|
6,648.01
|
11/1/2007,
2:21 PM
