WELL CARE HMO, INC., D/B/A STAYWELL
HEALTH PLAN OF FLORIDA Medicaid HMO Contract
AHCA CONTRACT NO. FA522
AMENDMENT NO. 6
THIS CONTRACT, entered into between the STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, hereinafter referred to as the " Agency" and WELL CARE HMO, INC., d/b/a STAYWELL HEALTH PLAN OF FLORIDA, hereinafter referred to as the " Vendor" , is hereby amended as follows:
1. Standard Contract, Section II.A, Contract Amount, the first sentence is hereby amended to now read: To pay for contracted services according to the conditions of Attachment I in an amount not to exceed $655,855,250.00 (an increase of $2,887,417.00), subject to the availability of funds. 2. Attachment I, section 90.0, Payment and Authorized Enrollment Levels, Table 2 is hereby amended to read as follows:
Table 2.
Area wide Age-banded Capitation Rates for All Agency Areas of the State other than Areas 3, 5, 6, and 7 (Orange, Osceola, and Seminole counties).
Area 07 General Rates Plan - 015016913 (BREVARD) <1 year 1-5 6-13 14-20 Male 14-20 Female 21-54 Male 21-54 Female 55-64 65+ TANF/FC/SOBRA 337.19 75.53 47.77 52.81 108.40 134.29 204.16 286.57 286.57 SSI/No Medicare 3217.89 389.79 203.90 213.35 213.35 610.58 610.58 589.11 589.11 SSI/Part B 265.77 265.77 265.77 265.77 265.77 265.77 265.77 265.77 265.77 SSI/Part A & B 283.96 283.96 283.96 283.96 283.96 283.96 283.96 283.96 198.62
Area 08 General Rates Plan - 015016911 (LEE) 015016914 (SARASOTA) <1 year 1-5 6-13 14-20 Male 14-20 Female 21-54 Male 21-54 Female 55-64 65+ TANF/FC/SOBRA 296.66 66.37 41.76 46.19 95.19 117.62 179.02 250.96 250.96 SSI/No Medicare 3079.30 371.80 192.49 201.68 201.68 577.71 577.71 557.45 557.45 SSI /Part B 243.56 243.56 243.56 243.56 243.56 243.56 243.56 243.56 243.56 SSI/Part A & B 285.08 285.08 285.08 285.08 285.08 285.08 285.08 285.08 199.47
Area 09 General Rates Plan - 015016910 (PALM BEACH) <1 year 1-5 6-13 14-20 Male 14-20 Female 21-54 Male 21-54 Female 55-64 65+ TANF/FC/SOBRA 316.78 70.74 44.52 49.17 101.48 125.24 190.60 266.97 266.97 SSI/No Medicare 3344.05 405.22 211.12 221.15 221.15 633.22 633.22 610.93 610.93 SSI/Part B 267.20 267.20 267.20 267.20 267.20 267.20 267.20 267.20 267.20 SSI/Part A & B 320.32 320.32 320.32 320.32 320.32 320.32 320.32 320.32 224.19
Area 10 General Rates Plan - 015016900 (BROWARD) ...
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