Attached files
| file | filename |
|---|---|
| 10-K - FORM 10-K - IASIS Healthcare LLC | c09301e10vk.htm |
| EX-21 - EXHIBIT 21 - IASIS Healthcare LLC | c09301exv21.htm |
| EX-4.8 - EXHIBIT 4.8 - IASIS Healthcare LLC | c09301exv4w8.htm |
| EX-31.1 - EXHIBIT 31.1 - IASIS Healthcare LLC | c09301exv31w1.htm |
| EX-10.19 - EXHIBIT 10.19 - IASIS Healthcare LLC | c09301exv10w19.htm |
| EX-10.50 - EXHIBIT 10.50 - IASIS Healthcare LLC | c09301exv10w50.htm |
| EX-10.49 - EXHIBIT 10.49 - IASIS Healthcare LLC | c09301exv10w49.htm |
| EX-10.21 - EXHIBIT 10.21 - IASIS Healthcare LLC | c09301exv10w21.htm |
| EX-31.2 - EXHIBIT 31.2 - IASIS Healthcare LLC | c09301exv31w2.htm |
Exhibit 10.20
|
ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM ADMINISTRATION DIVISION OF BUSINESS AND FINANCE SECTION A: CONTRACT |
1. AMENDMENT
|
2. CONTRACT | 3. EFFECTIVE DATE OF | 4. PROGRAM | |||
| NUMBER: | NO.: | AMENDMENT: | ||||
11
|
YH09-0001-04 | October 1, 2009 | DHCM – ACUTE |
5. CONTRACTOR’S NAME AND ADDRESS:
Health Choice Arizona
410 N. 44th Street, Suite 900
Phoenix, AZ 85008
410 N. 44th Street, Suite 900
Phoenix, AZ 85008
6. PURPOSE
OF AMENDMENT: To amend Section B, Capitation Rates, to allow for
payment of retroactive rural
hospital inpatient reimbursement, effective October 1, 2009 through September 30, 2010.
7. THE CONTRACT REFERENCED ABOVE FOLLOWS
ADD
to Section B, CAPITATION RATES after
first subparagraph add the following language:
The Contractor will be paid the attached supplemental payment amounts to increase rural hospital
inpatient reimbursement. The supplemental payment amounts are allocated to the appropriate risk
groups based on historical utilization. AHCCCS requires that the Contractor them make one-time
payments to each rural hospital as prescribed on the attached schedule, pursuant A.R.S. §38-2005 02,
to Increase inpatient reimbursement to these small rural hospitals.
The Contractor shall make the prescribed payments to the rural hospitals 15 days from receipt of
the funds and submit proof of payment to the rural hospitals to the Assistant Director of the
Division of Health Care Management 30 days from receipt of the funds.
The regular per member per month capitation rates for the period of October 1, 2009 through
September 30, 2010, are not impacted by this amendment.
NOTE:
Please sign, date, and return executed file by E-Mail to: Mark Held at Mark.Held@azahcccs.gov
Sr. Procurement Specialist, AHCCCS Contracts and Purchasing
and Steward McKenzie at Steward.McKenzie@azahcccs.gov
and Steward McKenzie at Steward.McKenzie@azahcccs.gov
8. EXCEPT
AS PROVIDED FOR HEREIN, ALL TERMS AND CONDITIONS OF THE ORIGINAL
CONTRACT NOT HERETOFORE
CHANGED AND/OR AMENDED REMAIN UNCHANGED AND IN FULL EFFECT.
IN
WITNESS WHEREOF THE PARTIES HERETO SIGN THEIR NAMES IN AGREEMENT
9. SIGNATURE OF AUTHORIZED REPRESENTATIVE: /s/ Carolyn Rose |
10: SIGNATURE OF AHCCCSA CONTRACTING OFFICER: /s/ Michael Veit |
|
TYPED NAME: CAROLYN ROSE
|
TYPED NAME: MICHAEL VEIT | |
TITLE: CHIEF EXECUTIVE OFFICER
|
TITLE: CONTRACTS & PURCHASING ADMINISTRATOR | |
DATE: 11/2/10
|
DATE: OCT 8 2010 |
ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM
ACUTE SUPPLEMENTAL PAYMENT SUMMARY – Rural
Health Choice Arizona
CYE 2010
ACUTE SUPPLEMENTAL PAYMENT SUMMARY – Rural
Health Choice Arizona
CYE 2010
Supplemental Payment Related To:
| TANF | TANF | SSI | SSI | Total | ||||||||||||||||||||
| Supplemental Payment: | <1 M/F | 14-44 F | w/ Med | w/o Med | Non-MED | Payment | ||||||||||||||||||
4 Apache/Coconino/Mohave/ Navajo |
$ | 582,995.18 | $ | 1,109,571.48 | $ | 178,467.91 | $ | 257,147.32 | $ | 654,382.35 | $ | 2,782,564.24 | ||||||||||||
10 Pima/Santa Cruz |
$ | 119,746.21 | $ | 179,019.32 | $ | 18,422.49 | $ | 13,616.87 | $ | 19,573.90 | $ | 351,178.79 | ||||||||||||
| $ | 3,133,743.03 | |||||||||||||||||||||||
Two percent Premium tax is included in the Supplemental Capitation Payments.
Payments to the hospitals stated without Premium tax.
| Health Choice Arizona | Payment | |||
Benson Hospital |
$ | — | ||
Carondolet Holy Cross |
$ | 217,862.31 | ||
Cobre Valley Community Hospital |
$ | — | ||
Copper Queen Community Hospital |
$ | — | ||
La Paz Regional Hospital |
$ | 77,347.64 | ||
Little Colorado Medical Center |
$ | 378,953.09 | ||
Mount Graham Regional Medical Center |
$ | — | ||
Summit Healthcare Regional Medical Center |
$ | 1,302,758.78 | ||
Northern Cochise Community Hospital |
$ | — | ||
Page Hospital |
$ | 156,347.39 | ||
Payson Regional Medical Center |
$ | — | ||
Sage Memorial Hospital |
$ | 94,828.54 | ||
Sierra Vista Regional Health |
$ | — | ||
Southeastern Az Medical Center |
$ | — | ||
Valley View Medical Center |
$ | 791,629.41 | ||
Verde Valley Medical Center |
$ | — | ||
White Mountain Regional Medical Center |
$ | 51,141.01 | ||
Wickenburg Regional Health Center |
$ | — | ||
YRMC East |
$ | — | ||
Total Payments |
$ | 3,071,068.17 | ||
Premium Tax |
$ | 62,674.86 | ||
Total with Premium Tax |
$ | 3,133,743.03 | ||