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Medicare Advantage Contract Amendment

(For use with Administrative / Management Contracts and First Tier or Downstream Entity Provider Contracts)
CMS requires that specific terms and conditions be incorporated into the Agreement between a
Medicare Advantage Organization or First Tier Entity and a First Tier Entity or Downstream Entity
to comply with the Medicare laws, regulations, and CMS instructions, including, but not limited to,
the Medicare Prescription Drug, Improvement and Modernization Act of 2003, Pub. L. No. 108173, 117 Stat. 2066 (“MMA”); and
Except as provided herein, all other provisions of the Agreement between [{MA Organization
Name or Entity} and {Entity}] not inconsistent herein shall remain in full force and effect. This
amendment shall supersede and replace any inconsistent provisions to such Agreement; to ensure
compliance with required CMS provisions, and shall continue concurrently with the term of such
NOW, THEREFORE, the parties agree as follows: