Attached files
file | filename |
---|---|
10-K - FORM 10-K - IASIS Healthcare LLC | d275632d10k.htm |
EX-31.2 - EX-31.2 - IASIS Healthcare LLC | d275632dex312.htm |
EX-31.1 - EX-31.1 - IASIS Healthcare LLC | d275632dex311.htm |
EX-21 - EX-21 - IASIS Healthcare LLC | d275632dex21.htm |
EX-10.28 - EX-10.28 - IASIS Healthcare LLC | d275632dex1028.htm |
EX-10.26 - EX-10.26 - IASIS Healthcare LLC | d275632dex1026.htm |
EX-10.24 - EX-10.24 - IASIS Healthcare LLC | d275632dex1024.htm |
EX-10.21 - EX-10.21 - IASIS Healthcare LLC | d275632dex1021.htm |
EX-10.20 - EX-10.20 - IASIS Healthcare LLC | d275632dex1020.htm |
EX-10.19 - EX-10.19 - IASIS Healthcare LLC | d275632dex1019.htm |
EX-10.17 - EX-10.17 - IASIS Healthcare LLC | d275632dex1017.htm |
EX-10.14 - EX-10.14 - IASIS Healthcare LLC | d275632dex1014.htm |
EX-10.13 - EX-10.13 - IASIS Healthcare LLC | d275632dex1013.htm |
EX-10.12 - EX-10.12 - IASIS Healthcare LLC | d275632dex1012.htm |
Exhibit 10.18
CONTRACT AMENDMENT | ARIZONA DEPARTMENT | |||||
OF HEALTH SERVICES | ||||||
1740 W. Adams, Room 303 | ||||||
Phoenix, Arizona 85007 | ||||||
Contract No: ADHS15-085892 | Amendment No. 2 | (602) 542-1040 | ||||
Procurement Specialist Ana Shoshtarikj |
PROGRAM: Behavioral Health Services Administration Health Choice Integrated Care-HCIC
Effective October 1, 2015, it is mutually agreed that the Contract referenced is amended as follows:
1. | Pursuant to Uniform Terms and Conditions, Paragraph 5. Contract Changes, 1. Amendments and Special Terms and Conditions, Paragraph 16. Contract Changes, Exhibit 11 Capitation Rates are hereby replaced with the CAPITATION RATES of this amendment. |
All other provisions shall remain in their entirety.
Contractor hereby acknowledges receipt and acceptance of above amendment and that a signed copy must be filed with the Procurement Office before the effective date. | The above referenced Contract Amendment is hereby executed this | |||||
day of , 2015 | ||||||
at Phoenix, Arizona | ||||||
|
||||||
Signature | Date | |||||
Authorized Signatorys Name and Title: | Procurement Officer: | |||||
Mary Jo Gregory |
||||||
Contractors Name: | ||||||
HEALTH CHOICE INTEGRATED CARE |
1
CONTRACT AMENDMENT | ARIZONA DEPARTMENT | |||||
OF HEALTH SERVICES | ||||||
1740 W. Adams, Room 303 | ||||||
Phoenix, Arizona 85007 | ||||||
Contract No: ADHS15-085892 | Amendment No. 2 | (602) 542-1040 | ||||
Procurement Specialist Ana Shoshtarikj |
EXHIBIT 11
CAPITATION RATES
CONTRACT NO: AHDS15-085892
Health Choice Integrated Care | ||||
Capitation Rate for GSA 7 | ||||
Effective Dates October 1, 2015 to September 30, 2016 | ||||
Title XIX and Title XXI eligible children, under the age of 18 (represents the cost of providing covered behavioral health services to children), not enrolled in CMDP: |
$ | 39.14 pm/pm | ||
Title XIX eligible children, under the age of 18 (represents the cost of providing covered behavioral health services to children), enrolled in CMDP: |
$ | 1,273.31 pm/pm | ||
Title XIX and Title XXI eligible adults, age 18 and older (represents the cost of providing covered behavioral health services to adult members without serious mental illness): |
$ | 39.42 pm/pm | ||
Title XIX eligible adults, age 18 and older (represents the cost of providing covered behavioral health services to adult members with serious mental illness, who are not receiving physical health services under this contract): |
$ | 2.92 pm/pm | ||
Title XIX eligible adults, age 18 and older (represents the cost of providing covered behavioral health services to adult members with serious mental illness, who are receiving physical health services under this contract): |
$ | 1,467.89 pm/pm | ||
DES DD ALTCS eligible children representing the cost of providing covered behavioral health services to DES DD ALTCS children. |
$ | 334.85 pm/pm | ||
DES DD ALTCS eligible adults representing the cost of providing covered behavioral health services to DES DD ALTCS adults. |
$ | 147.57 pm/pm |
2