2022 Amendment to the agreement between My Choice WI and ADRC of Sauk County

This Amendment to the Agreement for Services Contract ID (the “Agreement) is effective

January 1, 2022, between My Choice Wisconsin Inc. (“MCW”) and ADRC of Sauk County(“Provider”).

WHEREAS the Wisconsin Department of Health Services (“DHS”) will provide funding to MCOs for the 2022 American Rescue Plan Act increase (the “ARPA increased Rate”), which My Choice will distribute to its eligible providers for a yet to be specified time (the “ARPA increase”); and

WHEREAS MCW and Provider agree to amend the Agreement to provide for the ARPA increase upon the

terms and conditions set forth below.

Providers are responsible for billing at the new ARPA rate effective 1/1/2022.