EX-10.6.12 2 w26714exv10w6w12.htm EX-10.6.12 exv10w6w12
 

Exhibit 10.6.12
         
    (SAEL)    
    State of New Jersey    
    DEPARTMENT OF HUMAN SERVICES    
    DIVISION OF MEDICAL ASSISTANCE AND HEALTH SERVICES    
JON S. CORZINE   P.O. Box 712   JAMES W. SMITH, JR.
Governor   Trenton, NJ 08625-0712   Acting Commissioner
    Telephone 1-800-356-1561    
         
    ANN CLEMENCY KOHLER    
    Director    
         
    July 18, 2006    
Peter D. Haytaian President and
CEO AMERIGROUP New Jersey,
Inc. 399 Thornall Street, 9th Floor
Edison, NJ 08837
Dear Mr. Haytaian:
Enclosed, for your signature, is a contract amendment for July 1, 2006. This amendment revises the HMO capitation rate, maternity payment and MCSA administration fees for SFY 2007. The rate certification letter and supporting documentation has also been provided to you under separate cover.
The increase of the capitation rates are required to compensate the HMOs for the SFY 2007 Budget Appropriation Bill increasing the HMO premium tax from one percent to two percent.
Please return the signed amendment by close of business July 26, 2006.
     
 
  Sincerely,
 
    
 
  Jill Simone, MD
 
  Executive Director
 
  Office of Managed Health Care
     
Enclosure
JS:
  H:v
c:
  John Koehn
 
  Jennifer Langer
New Jersey Is An Equal Opportunity Employer

 

 

STATE OF NEW JERSEY
DEPARTMENT OF HUMAN SERVICES
DIVISION OF MEDICAL ASSISTANCE AND HEALTH SERVICES
AND
AMERIGROUP NEW JERSEY, INC.
AGREEMENT TO PROVIDE HMO SERVICES
In accordance with Article 7, section 7.11.2A, 7.11.2B and 7.12.1 of the contract between AMERIGROUP New Jersey, Inc. and the State of New Jersey, Department of Human Services, Division of Medical Assistance and Health Services (DMAHS), effective date October 1, 2000, all parties agree that the contract shall be amended, effective July 1, 2006, as follows:
Appendix, Section C, “Capitation Rates” shall be revised as reflected in SFY 2007 Capitation Rates attached hereto and incorporated herein.

 

 

All other terms and conditions of the October 1, 2000 contract and subsequent amendments remain unchanged except as noted above.
The contracting parties indicate their agreement by their signatures.
                     
    AMERIGROUP       State of New Jersey    
    New Jersey, Inc.       Department of Human Services    
 
                    
BY:
  /s/ [ILLEGIBLE]       BY:   Ann Clemency Kohler    
 
 
 
                
 
                    
TITLE:
  President and CEO       TITLE:   Director, DMAHS    
 
                    
DATE:
  7/25/06       DATE:        
 
                    
APPROVED AS TO FORM ONLY                
 
                    
Attorney General State of New Jersey                
 
                    
BY:
  Deputy Attorney General                
 
                    
DATE:
                    
 
 
 
 		               

 

 

SECTION C
CAPITATION RATES

 

 

STATE OF NEW JERSEY
SFY 2007
MANAGED CARE CAPITATION RATES
AND MANAGED CARE SERVICES ADMINISTRATOR FEES
                                         
            Contract Period: 07/01/2006 - 06/30/2007  
Category   Age/Sex     Northern     Central     Southern     Statewide  
AFDC/KidCare A/New Jersey Care Children
                                        
AFDC/KidCare A/New Jersey Care Children
                                        
AFDC/KidCare A/New Jersey Care Children/NJCPW
                                        
AFDC/ NJCPW
                                        
AFDC
                                        
AFDC/ NJCPW
                                        
Aged with Medicare
                                        
Blind/Disabled with Medicare and Other Dual Eligibles
                                        
Blind/Disabled with Medicare and Other Dual Eligibles   *******REDACTED*******
Maternity
                                        
ABD-DDD with Medicare and Other Dual Eligibles
                                        
ABD (including AIDS & DDD) without Medicare — non-DDD
                                        
ABD (including AIDS & DDD) without Medicare — DDD &
                                        
Non ABD-DDD
                                        
DYFS
                                        
DYFS
                                        
DYFS
                                        
KidCare B&C
                                        
KidCare B&C
                                        
KidCare B&C
                                        
KidCare D
                                        
KidCare D
                                        
KidCare D
                                        
FamilyCare Parents 0-133%
                                        
FamilyCare Parents 0-133%
                                        
FamilyCare Parents 0-133%
                                        
FamilyCare Parents 134-200%
                                        
FamilyCare Parents 134-200%
                                        
FamilyCare Parents 134-200%
                                        
AIDS-ABD with Medicare and Other Dual Eligibles
                                        
AIDS-Non-ABD
                                        
AIDS-ABD with Medicare and Other Dual Eligibles DDD (including Behavioral Health Add-On)
                                        
AIDS-Non-ABD DDD (including Behavioral Health Add-On)