Medicaid Supplemental Payment Program Support Agreement Sample Contracts
ContractMedicaid Supplemental Payment Program Support Agreement • September 13th, 2017
This Medicaid Supplemental Payment Program Support Agreement (“Agreement”) is entered into on the dates indicated below each signature and effective on the last of those dates (“Effective Date”) by and between the Arkansas Ambulance Association (“ArAA”) and the undersigned person or entity (“Participant”), individually and on behalf of one or more EMS providers as hereinafter provided (“Participating Providers”).
Standard Contracts
MEDICAID SUPPLEMENTAL PAYMENT PROGRAM SUPPORT AGREEMENTMedicaid Supplemental Payment Program Support Agreement • September 13th, 2017
Note: This contract is structured for one company or individual owning one or more agencies. If the agency is freestanding, then the “Participant” and the “Participating Provider” are the same. If the provider is owned by another company (alone or as part of a group of providers), then the “Participant” is the owners and the “Participating Providers” are the individual providers.
ARKANSAS AMBULANCE ASSOCIATION FIRST AMENDMENT TOMEDICAID SUPPLEMENTAL PAYMENT PROGRAM SUPPORT AGREEMENTMedicaid Supplemental Payment Program Support Agreement • December 23rd, 2020
This First Amendment (“Amendment”) to Medicaid Supplemental Payment Program Support Agreement (“Agreement”) is entered into on the dates indicated below each signature and effective on the last of those dates (“Effective Date”) by and between the Arkansas Ambulance Association (“ArAA”) and the undersigned person or entity (“Participant”), individually and on behalf of one or more EMS providers as hereinafter provided (“Participating Providers”).