doczyai-pipelines/archive/streamlit_multipage/Demo_Test_data.csv

1	Filename	Agreement_Name (Contract Title)	PAYER NAME	Health Plan State	Affiliate (Y/N)	Credentialing Application Indicator	Term Clause	Evergreen, Fixed or Hard Term	Termination Date	Termination Upon Notice - Days	Termination With Cause - Days	Amend Contract Upon notice Flag (Y/N)	Timeframe  to Object - Days	Assignments Clause  (Y/N)	Contract Effective Date	IRS #	IRS_Name	NPI (10-digits)	NPI_NAME	PROV_GROUP_TIN_SIGNATORY	PROV_TIN_OTHER	PROV_NPI_OTHER	Notice to Provider Name	Notice to Provider Address	Sequestration Language	Sequestration Reductions, included [Medicare only] (Y/N)	PROV_TIN_OTHER.1	PROV_NPI_OTHER.1	Parent Agreement Code	Pages	page_num	Attachment/Exhibit	Line of Business	Provider Type	Provider Type - Level 2	Service Type	Plan Type	Lesser of Logic Language, included (Y/N)	Lesser of Rate	Reimb. Methodology	Reimb. Methodology_short	If rate is % of Payer or MCR [STANDARD]	If rate is % of Payer or MCR [STANDARD]_Short	If rate is Flat Fee [STANDARD]	Default Term	Default Rate	Inclusion of essential RBRVS "Fee Source" Language (Y/N)	CDM Neutralization Language, included (Y/N)	Chargemaster Protection Language	Exclusions	Not to Exceed	Escalator or COLA (Y/N)	Escalator I, Eff. Date	IP/OP	IP - DSH/IME/UC, included (Y/N)	IP - Stoploss Catastrophic Threshold
2	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	Inpatient Covered Services - Medical/Surgical		N		103.5 percent of the applicable CMS Medicare Inpatient Prospective Payment (IPPS) rates of Medicare Severity Diagnosis Related Groups (MS-DRGs) published on the CMS website on the date of the Member's discharge, including associated add-on and outlier payments as determined by CMS. All costs that are excluded by CMS from the IPPS rate will not be paid by Health Plan.	103.% of MCR	103.5% of MCR	1.035		All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N		All costs that are excluded by CMS from the IPPS rate will not be paid by Health Plan.		N		IP	N
3	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	Inpatient Covered Services - Inpatient Rehabilitation		N		103.5 percent of Health Plan's Medicare rate schedule based on the applicable CMS Medicare Case-Mix Group (CMG) rates for inpatient rehabilitation published on the CMS website on the date of the Member's discharge.	103.% of MCR	103.5% of MCR	1.035		All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				N		IP	N
4	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	Inpatient Covered Services - Inpatient psychiatric /Alcohol/Substance Abuse Covered Services rendered to Member in an inpatient psychiatric facility or unit within the Provider's hospital facility		N		$1,750 per diem	Flat Fee			$1,750 Per Diem	All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				Y	1-Apr-22	IP	N
5	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	Specialty Hospital - IP Specialty Hospital for Long Term Acute Care: - IP Specialty Hospital for Long Term Acute Care Covered Services rendered to Member within Henry J. Carter Specialty Hospital		N		$2,250 per diem (Non-COVID 19 Diagnosis) $2,750 per diem (COVID19 Diagnosis: ICD. 10 Code - U07.1) $350 per treatment (Dialysis Add-On: Rev Codes 0800-0809)	Flat Fee			$2,250 Per Diem (Non-COVID 19 Diagnosis) / $2,750 Per Diem (COVID19 Diagnosis) / $350 Per Treatment (Dialysis Add-On)	All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				Y	1-Apr-22	IP	N
6	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	Outpatient Covered Services - Emergency Room (technical only, not inclusive of physician services)		N		110 percent of the applicable CMS Medicare Outpatient Prospective Payment System (OPPS)/APC rates published on the CMS website on the date the Covered Service is rendered.	% of MCR	110% of MCR	1.1		All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				N		OP
7	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	Outpatient Covered Services - Urgent Care (Per Visit) (Rev Code 0516)		N		150 percent of the applicable CMS Medicare Outpatient Prospective Payment System (OPPS)/APC rates published on the CMS website on the date the Covered Service is rendered.	% of MCR OPPS/APC rates	150% of MCR OPPS/APC rates	1.5		All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				N		OP
8	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	Outpatient Covered Services - Ambulatory Surgery (Including but not limited to Lithotripsy, PTCA, Cardiac Cath, Laparoscopy)		N		110 percent of the applicable CMS Medicare Outpatient Prospective Payment System (OPPS)/APC rates published on the CMS website on the date the Covered Service is rendered.	% of MCR	110% of MCR	1.1		All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				N		OP
9	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	Outpatient Covered Services - Observation		N		110 percent of the applicable CMS Medicare Outpatient Prospective Payment System (OPPS)/APC rates published on the CMS website on the date the Covered Service is rendered.	% of MCR	110% of MCR	1.1		All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				N		OP
10	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	Outpatient Covered Services - PT/OT/ST (Per Visit)		N		110 percent of the applicable CMS Medicare Outpatient Prospective Payment System (OPPS)/APC rates published on the CMS website on the date the Covered Service is rendered.	% of MCR	110% of MCR	1.1		All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				N		OP
11	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	Outpatient Covered Services - Dialysis		N		110 percent of the End Stage Renal Dialysis (ESRD) Prospective Payment System (PPS) rates published on the CMS website on the date the Covered Service is rendered.	% of ESRD PPS rates	110% of ESRD PPS rates	1.1		All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				N		OP
12	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	Outpatient Covered Services - Chemotherapy Administration (Excludes Drugs)		N		110 percent of the applicable CMS Medicare Outpatient Prospective Payment System (OPPS)/APC rates published on the CMS website on the date the Covered Service is rendered.	% of MCR	110% of MCR	1.1		All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N		Excludes Drugs		N		OP
13	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	Outpatient Covered Services - Behavioral Health: -Intensive Outpatient Mental Health / Substance Abuse -Partial Hospitalization -Continuing Day Treatment -ECT -Ambulatory Detox -Telehealth Services		N		110 percent of the applicable CMS Medicare Outpatient Prospective Payment System (OPPS)/APC rates published on the CMS website on the date the Covered Service is rendered.	% of MCR	110% of MCR	1.1		All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				N		OP
14	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	Outpatient Covered Services - Lab/Radiology/Pathology		N		110 percent of the applicable CMS Medicare Outpatient Prospective Payment System (OPPS)/APC rates published on the CMS website on the date the Covered Service is rendered.	% of MCR	110% of MCR	1.1		All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				N		OP
15	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	Outpatient Covered Services - Radiation Therapy Hyperbaric Therapy		N		110 percent of the applicable CMS Medicare Outpatient Prospective Payment System (OPPS)/APC rates published on the CMS website on the date the Covered Service is rendered.	% of MCR	110% of MCR	1.1		All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				N		OP
16	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	Outpatient Covered Services - MRI / CAT Scan / PET Scan / Sonograms		N		110 percent of the applicable CMS Medicare Outpatient Prospective Payment System (OPPS)/APC rates published on the CMS website on the date the Covered Service is rendered.	% of MCR OPPS/APC rates	110% of MCR OPPS/APC rates	1.1		All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				N		OP
17	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	Outpatient Covered Services - Trauma Activation Fees (Rev Codes 0681-0684)		N		60% of Charges	% of BC	60% of BC	0.6		All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				N		OP
18	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	Outpatient Covered Services - All Other Outpatient Services (including clinic and DTC services)		N		110 percent of the applicable CMS Medicare Outpatient Prospective Payment System (OPPS)/APC rates published on the CMS website on the date the Covered Service is rendered or other successor CMS methodology as applicable.	% of MCR	110% of MCR	1.1		All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				N		OP
19	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	FQHC	FQHC Services (Payment Codes G0466-G0470)		N		110 percent of the applicable CMS Medicare FQHC Prospective Payment System rates published on the CMS website on the date the Covered Service is rendered or other successor CMS methodology as applicable.	% of MCR	110% of MCR	1.1		All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				N
20	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	All other outpatient services not priced by Medicare		N		115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	% of MCD	115% of MCD	1.15		All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				N		OP
21	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	Primary Care Services: (CPT-4 Codes 99201-99499)		N		110 percent of the CMS Medicare physician fee schedule for the applicable locality published on the CMS website on the date the Covered Services are rendered.	% of MCR	110% of MCR	1.1		All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				N
22	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	OBGYN Maternity Care and Deliveries: (CPT-4 Codes 59000-59622)		N		110 percent of the CMS Medicare physician fee schedule for the applicable locality published on the CMS website on the date the Covered Services are rendered.	% of MCR	110% of MCR	1.1		All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				N
23	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	Specialty Services		N		103.5 percent of the CMS Medicare physician fee schedule for the applicable locality published on the CMS website on the date the Covered Services are rendered.	103.% of MCR	103.5% of MCR	1.035		All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				N
24	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	Anesthesia Conversion Factor (15 Minute Time Units) (CPT-4 Codes 00100 to 01999)		N		$45 per unit	Flat Fee			$45 per unit	All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				Y	1-Apr-22
25	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	Telehealth Services		N		103.5 percent of the CMS Medicare physician fee schedule for the applicable locality published on the CMS website on the date the Covered Services are rendered.	103.% of MCR	103.5% of MCR	1.035		All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				N
26	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	Allied Health Professionals		N		85 percent of the CMS Medicare Primary Care Services fee schedule referenced above for the applicable locality published on the CMS website on the date the Covered Services are rendered.	% of MCR	85% of MCR	0.85		All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				N
27	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	All other Specialties		N		103.5 percent of the CMS Medicare physician fee schedule for the applicable locality published on the CMS website on the date the Covered Services are rendered.	103.% of MCR	103.5% of MCR	1.035		All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				N
28	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	37	ATTACHMENT C-1 MEDICARE ADVANTAGE PROGRAM COMPENSATION (HOSPITAL AND PROFESSIONAL)	MEDICARE ADVANTAGE	Facility	Hospital	All other professional services not priced by Medicare		N		115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	% of MCD	115% of MCD	1.15		All other outpatient services not priced by Medicare | 115 percent of the applicable NYS Medicaid rate. If no price, 60% of Charges.	60% of Charges	N	N				N
29	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	41	ATTACHMENT C-2 MEDICARE ADVANTAGE COMPENSATION (SKILLED NURSING FACILITY & HOME HEALTH SERVICES) (FEE FOR SERVICE)	MEDICARE ADVANTAGE	Facility	Skilled Nursing Facility	Health Plan's Medicare SNF Per Diem Rate Table - Level 1		N		Level 1 | $575 | 191	Flat Fee			$575			N	N				Y	1-Apr-22
30	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	41	ATTACHMENT C-2 MEDICARE ADVANTAGE COMPENSATION (SKILLED NURSING FACILITY & HOME HEALTH SERVICES) (FEE FOR SERVICE)	MEDICARE ADVANTAGE	Facility	Skilled Nursing Facility	Health Plan's Medicare SNF Per Diem Rate Table - Level 2		N		Level 2 | $675 | 192	Flat Fee			$675			N	N				Y	1-Apr-22
31	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	41	ATTACHMENT C-2 MEDICARE ADVANTAGE COMPENSATION (SKILLED NURSING FACILITY & HOME HEALTH SERVICES) (FEE FOR SERVICE)	MEDICARE ADVANTAGE	Facility	Skilled Nursing Facility	Health Plan's Medicare SNF Per Diem Rate Table - Level 3		N		Level 3 | $725 | 193	Flat Fee			$725			N	N				Y	1-Apr-22	IP	N
32	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	41	ATTACHMENT C-2 MEDICARE ADVANTAGE COMPENSATION (SKILLED NURSING FACILITY & HOME HEALTH SERVICES) (FEE FOR SERVICE)	MEDICARE ADVANTAGE	Facility	Skilled Nursing Facility	Health Plan's Medicare Specialty SNF Per Diem Rate Table - Traumatic Brain Injury (Seaview Only)		N		Traumatic Brain Injury (Seaview Only) | $875 | 199	Flat Fee			$875			N	N				Y	1-Apr-22
33	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	41	ATTACHMENT C-2 MEDICARE ADVANTAGE COMPENSATION (SKILLED NURSING FACILITY & HOME HEALTH SERVICES) (FEE FOR SERVICE)	MEDICARE ADVANTAGE	Facility	Skilled Nursing Facility	Health Plan's Medicare Specialty SNF Per Diem Rate Table - Ventilator (Harry J. Carter Only)		N		Ventilator (Harry J. Carter Only) | $1,325 | 199	Flat Fee			$1,325			N	N				Y	1-Apr-22
34	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	41	ATTACHMENT C-2 MEDICARE ADVANTAGE COMPENSATION (SKILLED NURSING FACILITY & HOME HEALTH SERVICES) (FEE FOR SERVICE)	MEDICARE ADVANTAGE	Facility	Skilled Nursing Facility	Covered Services		N		Effective April 1, 2022, services priced at a flat rate shall be increased by 3% annually up to year 3 through March 31, 2024.	% of AC	3% of AC	0.03				N	N				Y	1-Apr-22
35	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	41	ATTACHMENT C-2 MEDICARE ADVANTAGE COMPENSATION (SKILLED NURSING FACILITY & HOME HEALTH SERVICES) (FEE FOR SERVICE)	MEDICARE ADVANTAGE	Facility		Home Health Care - Skilled Nursing		N		Skilled Nursing | 551 | $180 per visit	Flat Fee			$180 per visit			N	N				Y	1-Apr-22
36	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	41	ATTACHMENT C-2 MEDICARE ADVANTAGE COMPENSATION (SKILLED NURSING FACILITY & HOME HEALTH SERVICES) (FEE FOR SERVICE)	MEDICARE ADVANTAGE	Facility		Home Health Care - LPN		N		LPN | 550 | $180 per visit	Flat Fee			$180 per visit			N	N				Y	1-Apr-22
37	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	41	ATTACHMENT C-2 MEDICARE ADVANTAGE COMPENSATION (SKILLED NURSING FACILITY & HOME HEALTH SERVICES) (FEE FOR SERVICE)	MEDICARE ADVANTAGE	Facility		Home Health Care - Medical Social Services		N		Medical Social Services | 561 | $230 per visit	Flat Fee			$230 per visit			N	N				Y	1-Apr-22
38	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	41	ATTACHMENT C-2 MEDICARE ADVANTAGE COMPENSATION (SKILLED NURSING FACILITY & HOME HEALTH SERVICES) (FEE FOR SERVICE)	MEDICARE ADVANTAGE	Facility		Home Health Care - Physical Therapy		N		Physical Therapy | 421 | $195 per visit	Flat Fee			$195 per visit			N	N				Y	1-Apr-22
39	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	41	ATTACHMENT C-2 MEDICARE ADVANTAGE COMPENSATION (SKILLED NURSING FACILITY & HOME HEALTH SERVICES) (FEE FOR SERVICE)	MEDICARE ADVANTAGE	Facility		Home Health Care - Speech Therapy		N		Speech Therapy | 441 | $215 per visit	Flat Fee			$215 per visit			N	N				Y	1-Apr-22
40	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	41	ATTACHMENT C-2 MEDICARE ADVANTAGE COMPENSATION (SKILLED NURSING FACILITY & HOME HEALTH SERVICES) (FEE FOR SERVICE)	MEDICARE ADVANTAGE	Facility		Home Health Care - Occupational Therapy		N		Occupational Therapy | 431 | $200 per visit	Flat Fee			$200 per visit			N	N				Y	1-Apr-22
41	13-2655001-New York City Health and Hospitals Corporation-ICMProviderAgreement_318243_1	PARTICIPATING PROVIDER AGREEMENT	WellCare of New York, Inc., WellCare Health Insurance of New York, Inc. and American Progressive Life and Health Insurance Company of New York	New York	Yes	Yes	7.1 Term. The term of this Agreement shall begin on the Effective Date and continue for a period of one year, and thereafter shall renew for successive periods of one year each unless a Party provides notice of nonrenewal to the other at least 90 days before the end of the then current (initial or renewal)term, unless and until the Agreement is terminated in accordance with the terms and conditions of the Agreement, including those in a Program Attachment.	Evergreen		90	90	Yes		Yes	4/1/2021	13-2655001	New York City Health and Hospitals Corporation							160 Water Street 6th Flr Rm 642 New York, NY 10038					318243	43	41	ATTACHMENT C-2 MEDICARE ADVANTAGE COMPENSATION (SKILLED NURSING FACILITY & HOME HEALTH SERVICES) (FEE FOR SERVICE)	MEDICARE ADVANTAGE	Facility		Home Health Care - Home Health Aide		N		Home Health Aide | 571 | $85 per visit	Flat Fee			$85 per visit			N	N				Y	1-Apr-22
42
43
44
45
46
47
48