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EXHIBIT 10.20
AMENDMENT SFY02-#01
TO THE
1999 CONTRACT FOR SERVICES
BETWEEN
TEXAS DEPARTMENT OF HUMAN SERVICES AND HMO
This Amendment No. SFY02-#01 is entered into between the Texas Department of
Human Services (TDHS) and AMERIGROUP TEXAS, INC.(HMO), to amend the Contract for
Services between the Texas Department of Human Services and HMO in the ▇▇▇▇▇▇
COUNTY Service Area. The effective date of this amendment is September 1, 2001.
The Parties agree to amend the Contract as follows:
1. Articles II, III, V, VI, VII, VII, X, XII, XIII, XV, XVI, XVIII and XIX are
amended by adding the new BOLD & ITALICIZED language.
2.0 DEFINITIONS
CHEMICAL DEPENDENCY TREATMENT FACILITY: A FACILITY LICENSED BY
THE TEXAS COMMISSION ON ALCOHOL AND DRUG ABUSE (TCADA) UNDER
SEC. 464.002 OF THE HEALTH AND SAFETY CODE TO PROVIDE CHEMICAL
DEPENDENCY TREATMENT.
CHEMICAL DEPENDENCY TREATMENT: TREATMENT PROVIDED FOR A
CHEMICAL DEPENDENCY CONDITION BY A CHEMICAL DEPENDENCY
TREATMENT FACILITY, CHEMICAL DEPENDENCY COUNSELOR OR HOSPITAL
CHEMICAL DEPENDENCY CONDITION: A CONDITION WHICH MEETS AT
LEAST THREE OF THE DIAGNOSTIC CRITERIA FOR PSYCHOACTIVE
SUBSTANCE DEPENDENCE IN THE AMERICAN PSYCHIATRIC ASSOCIATION'S
DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS (DSM
IV).
CHEMICAL DEPENDENCY COUNSELOR: AN INDIVIDUAL LICENSED BY TCADA
UNDER SEC. 504 OF THE OCCUPATIONS CODE TO PROVIDE CHEMICAL
DEPENDENCY TREATMENT OR A MASTER'S LEVEL THERAPIST (LMSW-ACP,
LMFT OR LPC) OR A MASTER'S LEVEL THERAPIST (LMSW-ACP, LMFT OR
LPC) WITH A MINIMUM OF TWO YEARS OF POST LICENSURE EXPERIENCE
IN CHEMICAL DEPENDENCY TREATMENT.
Experience rebate means: THE PORTION OF THE HMO'S NET INCOME
BEFORE TAXES (FINANCIAL STATISTICAL REPORT) THAT IS RETURNED
TO THE STATE IN ACCORDANCE WITH ARTICLE 13.2.1.
JOINT INTERFACE PLAN (JIP) MEANS A DOCUMENT USED TO
COMMUNICATE BASIC SYSTEM INTERFACE INFORMATION OF THE TEXAS
MEDICAID ADMINISTRATIVE SYSTEM (TMAS) AMONG AND ACROSS STATE
TMAS CONTRACTORS AND PARTNERS SO THAT ALL ENTITIES ARE AWARE
OF THE INTERFACES THAT AFFECT THEIR BUSINESS. THIS INFORMATION
INCLUDES: FILE STRUCTURE, DATA ELEMENTS, FREQUENCY, MEDIA,
TYPE OF FILE, RECEIVER AND SENDER OF THE FILE, AND FILE I.D.
THE JIP MUST INCLUDE EACH OF THE HMOS' INTERFACES REQUIRED TO
CONDUCT STATE TMAS BUSINESS. THE JIP MUST ADDRESS THE
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COORDINATION WITH EACH OF THE CONTRACTOR'S INTERFACE PARTNERS
TO ENSURE THE DEVELOPMENT AND MAINTENANCE OF THE INTERFACE;
AND THE TIMELY TRANSFER OF REQUIRED DATA ELEMENTS BETWEEN
CONTRACTORS AND PARTNERS.
3.5 RECORDS REQUIREMENTS AND RECORDS RETENTION
3.5.8 THE USE OF MEDICAID FUNDS FOR ABORTION IS PROHIBITED UNLESS
THE PREGNANCY IS THE RESULT OF A RAPE, INCEST, OR CONTINUATION
OF THE PREGNANCY ENDANGERS THE LIFE OF THE WOMAN. A PHYSICIAN
MUST CERTIFY IN WRITING THAT BASED ON HIS/HER PROFESSIONAL
JUDGMENT, THE LIFE OF THE MOTHER WOULD BE ENDANGERED IF THE
FETUS WERE CARRIED TO TERM. HMO MUST MAINTAIN A COPY OF THE
CERTIFICATION FOR THREE YEARS.
5.1.4 The HMO and the State shall develop and implement a method by
which Legislative intent related to incentives to improve the
quality of care in Long Term Care services and payment of
providers delivering services to members is accomplished.
6.6 BEHAVIORAL HEALTH CARE SERVICES - SPECIFIC REQUIREMENTS
6.6.12 CHEMICAL DEPENDENCY TREATMENT MUST CONFORM TO THE STANDARDS
SET FORTH IN THE TEXAS ADMINISTRATIVE CODE, TITLE 28, PART 1,
SUBCHAPTER HH.
6.8 TEXAS HEALTH STEPS (EPSDT)
6.8.3 Provider Education and Training. HMO must provide appropriate
training to all network providers and provider staff in the
providers' area of practice regarding the scope of benefits
available and the THSteps program. Training must include
THSteps benefits, the periodicity schedule for THSteps
checkups and immunizations, THE REQUIRED ELEMENTS OF A THSTEPS
MEDICAL SCREEN, PROVIDING OR ARRANGING FOR ALL REQUIRED LAB
SCREENING TESTS (INCLUDING LEAD SCREENING), and Comprehensive
Care Program (CCP) services available under the THSteps
program to Members under age 21 years. Providers must also be
educated and trained regarding the requirements imposed upon
the department and contracting HMOs under the Consent Decree
entered in ▇▇▇▇ vs. McKinney, et. Al., Civil Action No.
3:93CV65, in the United States District Court for the Eastern
District of Texas, Paris Division. Providers should be
educated and trained to treat each THSteps visit as an
opportunity for a comprehensive assessment of the Member. HMO
MUST REPORT PROVIDER EDUCATION AND TRAINING REGARDING THSTEPS
IN ACCORDANCE WITH ARTICLE 7.4.4.
6.14.15 HMO staff providing Care Coordination functions must be
located within the STAR+PLUS Service Delivery Area.
7.3 PROVIDER CONTRACTS
7.3.5 TDHS reserves the right and retains the authority to make
reasonable inquiry
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and conduct investigations into provider and Member complaints
against HMO or any intermediary entity with whom HMO contracts
to deliver health care services under this contract. TDHS may
impose appropriate sanctions and contract remedies to ensure
HMO compliance with the provisions of this contract.
7.6 MEMBER PANEL REPORTS
HMO must furnish each PCP with a current list of enrolled
Members enrolled or assigned to that Provider no later than 5
WORKING days after HMO receives the Enrollment File from the
Enrollment Broker each month.
7.8 PROVIDER QUALIFICATIONS - GENERAL
7.8 CHEMICAL DEPENDENCY TREATMENT FACILITY: A FACILITY LICENSED BY
THE TEXAS COMMISSION ON ALCOHOL AND DRUG ABUSE (TCADA) UNDER
SEC. 464.002 OF THE HEALTH AND SAFETY CODE TO PROVIDE CHEMICAL
DEPENDENCY TREATMENT.
CHEMICAL DEPENDENCY COUNSELOR: AN INDIVIDUAL LICENSED BY TCADA
UNDER SEC. 504 OF THE OCCUPATIONS CODE TO PROVIDE CHEMICAL
DEPENDENCY TREATMENT OR A MASTER'S LEVEL THERAPIST (LMSW-ACP,
LMFT OR LPC) WITH A MINIMUM OF TWO YEARS OF POST-LICENSURE
EXPERIENCE IN CHEMICAL DEPENDENCY TREATMENT.
7.11 SPECIALTY CARE PROVIDERS
7.11.1 HMO must maintain specialty providers, ACTIVELY SERVING WITHIN
THAT SPECIALTY, including pediatric specialty providers AND
CHEMICAL DEPENDENCY SPECIALTY PROVIDERS, within the network in
sufficient numbers and areas of practice to meet the needs of
all Members requiring specialty care services.
7.12 SPECIAL HOSPITALS AND SPECIALTY CARE FACILITIES
7.12.4 HMO must include all medically necessary specialty services
through its network specialists, sub-specialists and specialty
care facilities (e.g., children's hospitals, LICENSED CHEMICAL
DEPENDENCY TREATMENT FACILITIES and tertiary care hospitals).
8.2 MEMBER HANDBOOK
8.2.1 HMO must mail each newly enrolled Member a Member Handbook no
later than 5 WORKING days after HMO receives the Enrollment
File. The Member Handbook must be written at a 4th - 6th grade
reading comprehension level. The Member Handbook must contain
all critical elements specified by TDHS. See Appendix D,
Required Critical Elements, for specific details regarding
content requirements. HMO must submit a Member Handbook to
TDHS for approval prior to the effective date of the contract
unless previously approved (see Article 3.4.1 regarding the
process for plan materials review).
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8.3 MEMBER ID CARDS
HMO must issue a Member Identification Card (ID) to the Member
within 5 WORKING days from the date the HMO receives the
monthly Enrollment File from the Enrollment Broker. The ID
Card must include, at a minimum, the following: Member's name;
Member's Medicaid number; either the issue date of the card or
effective date of the PCP assignment; PCP's name, address, and
telephone number; name of HMO; name of IPA to which the
Member's PCP belongs, if applicable; the 24-hour, seven (7)
day a week toll-free telephone number operated by HMO; the
toll-free number for behavioral health care services; and
directions for what to do in an emergency. The ID Card must be
reissued if the Member reports a lost card, there is a Member
name change, if Member requests a new PCP, or for any other
reason which results in a change to the information disclosed
on the ID Card.
10.1 MODEL MIS REQUIREMENTS
10.1.3 HMO must have a system that can be adapted to the change in
Business Practices/Policies WITHIN THE TIMEFRAME NEGOTIATED
BETWEEN TDHS AND THE HMO.
10.1.3.1 HMO MUST NOTIFY TDHS OF MAJOR SYSTEMS CHANGES AND
IMPLEMENTATIONS. HMO IS REQUIRED TO PROVIDE AN IMPLEMENTATION
PLAN AND SCHEDULE OF PROPOSED SYSTEM CHANGE AT THE TIME OF
THIS NOTIFICATION.
10.1.3.2 The State CONDUCTS A SYSTEMS READINESS TEST TO VALIDATE THE
CONTRACTOR'S ABILITY TO MEET THE MMIS REQUIREMENTS. THIS IS
DONE THROUGH SYSTEMS DEMONSTRATION AND PERFORMANCE OF SPECIFIC
MMIS AND SUBSYSTEM FUNCTIONS. THE SYSTEM READINESS TEST MAY
INCLUDE A DESK REVIEW AND/OR AN ONSITE REVIEW AND IS CONDUCTED
FOR THE FOLLOWING EVENTS:
- A NEW PLAN IS BROUGHT INTO THE PROGRAM
- AN EXISTING PLAN BEGINS BUSINESS IN A NEW SDA
- AN EXISTING PLAN CHANGES LOCATION
- AN EXISTING PLAN CHANGES THEIR PROCESSING SYSTEM
10.1.3.3 DESK REVIEW. HMO MUST COMPLETE AND PASS SYSTEMS DESK REVIEW
PRIOR TO ONSITE SYSTEMS TESTING CONDUCTED BY THE STATE.
10.1.3.4 ONSITE REVIEW. HMO IS REQUIRED TO PROVIDE A DETAILED AND
COMPREHENSIVE DISASTER AND RECOVERY PLAN, AND COMPLETE AND
PASS AN ONSITE SYSTEMS FACILITY REVIEW DURING THE STATE'S
ONSITE SYSTEMS TESTING.
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10.1.3.5 HMO IS REQUIRED TO PROVIDE A CORRECTIVE ACTION PLAN IN
RESPONSE TO THE STATE'S SYSTEMS READINESS TESTING DEFICIENCIES
NO LATER THAN 10 BUSINESS DAYS AFTER NOTIFICATION OF
DEFICIENCIES BY TDHS.
10.1.3.6 HMO IS REQUIRED TO PROVIDE REPRESENTATION TO ATTEND AND
PARTICIPATE IN ANY MEDICAID MANAGED CARE SYSTEMS WORKGROUP.
10.1.9 HMO MUST SUBMIT A JOINT INTERFACE PLAN (JIP) IN A FORMAT
SPECIFIED BY TDHS. THE JIP WILL INCLUDE REQUIRED INFORMATION
ON ALL CONTRACTOR INTERFACES THAT SUPPORT THE MEDICAID
INFORMATION SYSTEMS. THE SUBMISSION OF THE JIP WILL BE IN
COORDINATION WITH OTHER TMAS CONTRACTORS AND IS DUE NO LATER
THAN 10 WORKING DAYS AFTER THE END OF EACH STATE FISCAL YEAR.
10.3 ENROLLMENT ELIGIBILITY SUBSYSTEM
(11) Send PCP assignment updates to the State OR ITS DESIGNEE, in
the format specified by the State OR ITS DESIGNEE. UPDATES CAN
BE SENT AS OFTEN AS DAILY BUT MUST BE SENT AT LEAST WEEKLY.
10.7 UTILIZATION/QUALITY IMPROVEMENT SUBSYSTEM
(14) HMO must electronically transmit MDS-HC information on
any Member living in the community and receiving long term
care services. The MDS-HC should be submitted within 30 days
of the initiation of long term care services. The MDS-HC must
be updated annually.
12.1 FINANCIAL REPORTS
12.1.1 MCFS Report. HMO must submit the Managed Care Financial
Statistical Report (MCFS) in the format provided by TDHS. The
report must be submitted to TDHS no later than 30 days after
the end of each state fiscal year quarter (i.e., Dec. 30,
March 30, June 30, Sept. 30) and must include complete AND
UPDATED financial and statistical information for each month
OF THE STATE FISCAL YEAR-TO-DATE REPORTING PERIOD. The MCFS
Report must be submitted for each claims processing
subcontractor in accordance with this Article. HMO must
incorporate financial and statistical data received by its
delegated networks (IPAs, ANHCs, Limited Provider Networks) in
its MCFS Report.
12.1.4 Final MCFS Reports. HMO must file two Final Managed Care
Financial-Statistical Reports AFTER THE END OF THE SECOND YEAR
OF THE CONTRACT FOR THE FIRST TWO-YEAR PORTION OF THE CONTRACT
AND AGAIN AFTER THE THIRD OF THE CONTRACT FOR THE THIRD YEAR
(SECOND PORTION) OF THE CONTRACT. The first final report must
reflect expenses incurred through the 90th day after the end
of THE FIRST TWO-YEAR PORTION OF THE CONTRACT AND AGAIN AFTER
THE END OF THE THIRD YEAR OF THE CONTRACT FOR THE THIRD YEAR
(SECOND PORTION) OF THE CONTRACT. The first final report must
be filed on
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or before the 120th day after the end of EACH PORTION OF the
contract. The second final report must reflect data completed
through the 334th day after the end of THE SECOND YEAR OF THE
CONTRACT FOR THE FIRST TWO YEAR PORTION OF THE CONTRACT AND
AGAIN AFTER THE END OF THE THIRD YEAR OF THE CONTRACT FOR THE
THIRD YEAR (SECOND PORTION) OF THE CONTRACT and must be filed
on or before the 365th day following the end of EACH PORTION
OF the contract
12.5 PROVIDER NETWORK REPORTS
12.5.3 PCP ERROR REPORT. HMO MUST SUBMIT TO THE ENROLLMENT BROKER AN
ELECTRONIC FILE SUMMARIZING CHANGES IN PCP ASSIGNMENTS. THE
FILE MUST BE SUBMITTED IN A FORMAT SPECIFIED BY TDHS AND CAN
BE SUBMITTED AS OFTEN AS DAILY BUT MUST BE SUBMITTED AT LEAST
WEEKLY. WHEN HMO RECEIVES A PCP ASSIGNMENT ERROR REPORT/FILE,
HMO MUST SEND CORRECTIONS TO TDHS OR ITS DESIGNEE WITHIN FIVE
WORKING DAYS.
13.1.2.1 Once HMO has received ITS capitation rates established by TDHS
for the second year of this contract, HMO may terminate this
contract as provided in Article 18.1.6. ONCE HMO HAS RECEIVED
ITS PROPOSED CAPITATION RATES FROM TDHS FOR THE THIRD YEAR OF
THIS CONTRACT, HMO MAY TERMINATE THIS CONTRACT AS PROVIDED IN
ARTICLE 18.1.6.
13.1.8 HMO renewal rates reflect program increases appropriated by
the 76th AND 77TH legislature for physician (to include
THSteps providers) and outpatient facility services. HMO must
report to TDHS any change in rates for participating
physicians (to include THSteps providers) and outpatient
facilities resulting from this increase. The report must be
submitted to TDHS at the end of the first quarter of the
FY2000, FY2001 AND FY2002 contract years according to the
deliverables matrix schedule set for HMO.
13.2 EXPERIENCE REBATE TO THE STATE
13.2.1 For the contract Period. HMO must pay to TDHS an experience
rebate calculated in accordance with the tiered rebate method
listed below based on the excess of allowable HMO STAR+PLUS
revenues over allowable HMO STAR+PLUS expenses as measured by
any positive amount on the Final Managed Care Financial
Statistical Report and confirmed by TDHS. TDHS reserves the
right to have an independent audit performed to verify the
information provided by HMO.
Graduated Rebate
NET INCOME BEFORE TAXES
as a Percentage of
Revenues HMO Share State Share
-------- --------- -----------
0% - 3% 100% 0%
Over 3% - 7% 75% 25%
Over 7% - 10% 50% 50%
Over 10% - 15% 25% 75%
Over 15% 0% 100%
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13.2.2.1 THE EXPERIENCE REBATE FOR THE HMO SHALL BE CALCULATED BY
APPLYING THE EXPERIENCE REBATE FORMULA IN ARTICLE 13.2.1 TO
THE SUM OF THE NET INCOME BEFORE TAXES (FINANCIAL STATISTICAL
REPORT, PART 1, LINE 7) FOR ALL STAR MEDICAID SERVICE AREAS
CONTRACTED BETWEEN THE STATE AND HMO.
13.2.5 There will be two settlements for payment(s) of the experience
rebate FOR FY 2000-2001 AND TWO SETTLEMENTS FOR PAYMENT(S) FOR
THE EXPERIENCE REBATE FOR FY 2002. The first settlement FOR
THE SPECIFIED TIME PERIOD shall equal 100 percent of the
experience rebate as derived from Line 7 of Part 1 (Net Income
Before Taxes) of the first final Managed Care Financial
Statistical (MCFS) Report and shall be paid on the same day
the first final MCFS Report is submitted to TDHS FOR THE
SPECIFIED TIME PERIOD. The second settlement shall be an
adjustment to the first settlement and shall be paid to TDHS
on the same day that the second final MCFS Report is submitted
to TDHS FOR THAT SPECIFIED TIME PERIOD if the adjustment is a
payment from HMO to TDHS. IF THE ADJUSTMENT IS A PAYMENT FROM
TDHS TO HMO, TDHS SHALL PAY SUCH ADJUSTMENT TO HMO WITHIN
THIRTY (30) DAYS OF RECEIPT OF THE SECOND FINAL MCFS REPORT.
TDHS or its agent may audit or review the MCFS report. If TDHS
determines that corrections to the MCFS reports are required,
based on a TDHS audit/review of other documentation acceptable
to TDHS, to determine an adjustment to the amount of the
second settlement, then final adjustment shall be made within
two years from the date that HMO submits the second final MCFS
report. HMO must pay the first and second settlements on the
due dates for the first and second final MCFS reports
respectively as identified in Article 12.1.4. TDHS may adjust
the experience rebate if TDHS determines HMO has paid
affiliates amounts for goods or services that are higher than
the fair market value of the goods and services in the service
area. Fair market value may be based on the amount HMO pays a
non-affiliate(s) or the amount another HMO pays for the same
or similar service in the service area. TDHS has final
authority in auditing and determining the amount of the
experience rebate.
15.6 ASSIGNMENT
15.6 This contract was awarded to HMO based on HMO's qualifications
to perform personal and professional services. HMO cannot
assign this contract without the written consent of TDHS. This
provision does not prevent HMO from subcontracting duties and
responsibilities to qualified subcontractors. If TDHS consents
to an assignment of this contract, a transition period of 90
days will run from the date the assignment is approved by TDHS
so that Members' services are not interrupted and, if
necessary, the notice provided for in Article 15.7 can be
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sent to Members. The assigning HMO must also submit a
transition plan, as set out in Article 18.2.1, subject to
TDHS's approval.
16.3 DEFAULT BY HMO
16.3.15 FAILURE OF HMO TO PERFORM A MATERIAL DUTY OR RESPONSIBILITY AS
SET OUT IN THIS CONTRACT IS A DEFAULT UNDER THIS CONTRACT IS A
DEFAULT UNDER THIS CONTRACT AND TDHS MAY IMPOSE ONE OR MORE OF
THE REMEDIES CONTAINED WITHIN ITS PROVISIONS AND ALL OTHER
REMEDIES AVAILABLE TO TDHS BY LAW OR IN EQUITY.
16.3.15.1 REMEDIES TO PERFORM A MATERIAL DUTY OR RESPONSIBILITY
ALL OF THE LISTED REMEDIES ARE IN ADDITION TO ALL OTHER
REMEDIES AVAILABLE TO TDHS BY LAW OR IN EQUITY, ARE JOINT AND
SEVERAL, AND MAY BE EXERCISED CONCURRENTLY OR CONSECUTIVELY.
EXERCISE OF ANY REMEDY IN WHOLE OR IN PART DOES NOT LIMIT TDHS
IN EXERCISING ALL OR PART OF ANY REMAINING REMEDIES.
FOR HMO'S FAILURE TO PERFORM AN ADMINISTRATIVE FUNCTION UNDER
THIS CONTRACT, TDHS MAY:
- TERMINATE THE CONTRACT IF THE APPLICABLE CONDITIONS SET OUT
IN ARTICLE 18.1.1 ARE MET;
- SUSPEND NEW ENROLLMENT AS SET OUT IN ARTICLE 18.3;
- ASSESS LIQUIDATED MONEY DAMAGES AS SET OUT IN ARTICLE 18.4;
AND/OR
- REQUIRE FORFEITURE OF ALL OR PART OF THE TDI PERFORMANCE
BOND AS SET OUT IN ARTICLE 18.9.
18.1 TERMINATION BY HMO
18.1.6 HMO may terminate this contract if TDHS fails to pay HMO as
required under Article XIII of this contract or otherwise
materially defaults in its duties and responsibilities under
this contract, or by giving notice no later than 30 days after
receiving the capitation rates for the second OR THIRD
contract yearS. Retaining premium, recoupment, sanctions, or
penalties that are allowed under this contract or that result
from HMO's failure to perform or HMO's default under the terms
of this contract is not cause for termination.
18.2.1.1 DUTIES OF CONTRACTING PARTIES UPON TERMINATION
18.2.2 If the contract is terminated by TDHS for any reason other
than federal or state funds for the Medicaid program no longer
being available or if HMO terminates the contract based on
lower capitation rates for the second OR THIRD contract yearS
as set out in Article ▇▇.▇.▇.▇:
18.2.3 If the contract is terminated by HMO for any reason other than
based on lower capitation rates for the second OR THIRD
contract years as set out in Article
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▇▇.▇.▇.▇:
Article XIX TERM
19.1 The effective date of this contract is September 1, 1999. This
contract will terminate on August 31, 2002, unless terminated
earlier as provided for elsewhere in the contract.
AGREED AND SIGNED by an authorized representative of the parties on
________________2001.
TEXAS DEPARTMENT OF AMERICAID TEXAS, INC.
HUMAN SERVICES
BY:_____________________________ BY:_____________________________
▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇▇ JR.
EXECUTIVE DEPUTY COMMISSIONER PRESIDENT AND CEO
DATE SIGNED:____________________ DATE SIGNED:____________________
APPROVED AS TO FORM:
____________________________
Office of General Counsel
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