2019-10-11T09:04:02-05:00 2018-12-31 221478099 COHNREZNICK LLP 1301 AVENUE OF THE AMERICAS NEW YORK NY 10019 990 2018-01-01 134154068 AMIDA CARE INC AMID 6467577000 14 PENN PLAZA 2ND FL NEW YORK NY 10122 DOUGLAS WIRTH PRESIDENT/CEO 6467577000 2019-10-10 1 LORI ROTHE YOKOBOSKY CPA P01273422 2122970400 2019-09-19 209.59.242.22 2019-10-10 16:51:44 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 FA2DBD1E862D536755A0BF62A387DF66AD4CE1F5 2018 2020-01-14 16:20:31Z DOUGLAS WIRTH 14 PENN PLAZA 2ND FL NEW YORK NY 10122 433246646 0 X WWW.AMIDACARENY.ORG X 2000 NY AMIDA CARE INC. IS A HEALTH MAINTENANCE ORGANIZATION FORMED TO OBTAIN A COMPREHENSIVE HIV SPECIAL NEEDS CERTIFICATE OF AUTHORITY IN ORDER TO PROVIDE OR ARRANGE FOR ALL MEDICAL ASSISTANCE SERVICES TO PERSONS ENROLLED IN THE PLAN AND FOR ASSISTING ENROLLEES IN THE PRUDENT SELECTION OF SERVICES. 11 11 217 12 0 222033 1296667 1794936 385628015 412082885 142425 199798 102041 88799 387169148 414166418 0 0 0 0 19699993 19430522 0 0 0 350367379 389419090 370067372 408849612 17101776 5316806 104672641 129575509 74611644 94106030 30060997 35469479 X AMIDA CARE IS A PRIVATE, NONPROFIT COMMUNITY HEALTH PLAN THAT SPECIALIZES IN PROVIDING COMPREHENSIVE HEALTH COVERAGE AND COORDINATED CARE TO NEW YORK CITY MEDICAID MEMBERS WITH CHRONIC CONDITIONS, INCLUDING HIV/AIDS AND BEHAVIORAL HEALTH DISORDERS. IN ADDITION TO MEDICAID, AMIDA CARE PARTICPATED IN THE MEDICARE ADVANTAGE PROGRAM FROM 2014 THROUGH 2016. 0 0 368056559 412182885 AMIDA CARE IS A MEDICAID MANAGED CARE PLAN THAT PROVIDES ASSISTANCE AND/OR ARRANGES FOR MEDICAL CARE AND NON-MEDICAL SUPPORT FOR PERSONS ENROLLED IN THE PLAN. STAFF ALSO ASSISTS ENROLLEES IN THE PRUDENT SELECTION OF SERVICES. THE PLAN COVERED 80,504 MEMBER MONTHS IN 2018. -11208 800 AMIDA CARE CONTRACTED WITH THE CENTERS FOR MEDICARE AND MEDICAID (CMS) AND PARTICPATED IN THE MEDICARE ADVANTAGE PROGRAM FROM 2014 THROUGH 2016. THE PLAN TERMINATED ITS MEDICARE ADVANTAGE CONTRACT EFFECTIVE DECEMBER 31, 2016. THERE ARE NO MEMBERS FOR 2018. THE PROGRAM SERVICE EXPENSES AND REVENUE REPORTED ON THIS 990 ARE FOR RUNOUT ACTIVITIES AND REPORTING DURING 2018 FOR SERVICES PROVIDED THROUGH DECEMBER 31, 2016. 368045351 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1731 0 1 217 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X DOUGLAS WIRTH CEO 6467577000 14 PENN PLAZA 2ND FLOOR NEW YORK NY 10122 PAUL VITALE CHAIRPERSON 0.50 X X 0 0 0 EMMA DEVITO VICE CHAIR 0.50 X X 0 0 0 CHARLES KING SECRETARY 0.50 X X 0 0 0 PAM MATTEL-THROUGH JULY 2018 MEMBER 0.50 X 0 0 0 RAUL RUSSI - FROM AUG 2018 MEMBER 0.50 X 0 0 0 HOLLY ARGENT-TARIQ MEMBER 0.50 X 0 0 0 JACQUELYN KILMER MEMBER 0.50 X 0 0 0 ROBERT HAYES MEMBER 0.50 X 0 0 0 ROMANO JOHNSON INDEPENDENT DIRECTOR 0.50 X 0 0 0 MICHELE STEELE INDEPENDENT DIRECTOR 0.50 X 0 0 0 ARTHUR WEBB INDEPENDENT DIRECTOR 0.50 X 0 0 0 C VIRGINA FIELDS INDEPENDENT DIRECTOR 0.50 X 0 0 0 DOUGLAS WIRTH PRESIDENT/CEO 40.00 X 639364 0 70667 FELICE D KUSSOY CHIEF FINANCIAL OFFICER 40.00 X 258028 0 25531 NICHOLAS LIGUORI EXECUTIVE VICE PRESIDENT 40.00 X 324860 0 9081 JEROME ERNST MD CHIEF MEDICAL OFFICER 40.00 X 282956 0 44106 MAURA MCGRATH CHIEF COMPLIANCE & PRIVACY OFFICER 40.00 X 208868 0 10014 TERRY LEACH VP OF PHARMACY 40.00 X 232533 0 39490 KEVIN STEFFENS VP OF HEALTH SERVICES OPERATIONS 40.00 X 186764 0 24711 SALVATORE GIUNTA VP OF INFORMATION TECHNOLOGY 40.00 X 235491 0 15884 SHEILA MAGUIRE DIR. DATA GOVERNANCE SOFTWARE DEVELO 40.00 X 178237 0 8899 SHELLY SIMA TOUSSI MD MEDICAL DIRECTOR 40.00 X 240533 0 14835 STEPHANE HOWZE VP OF MS/OMBUDSPERSON 40.00 X 206522 0 51836 2994156 0 315054 38 0 1 0 BEACON HEALTH STRATEGIES LLC 200 STATE STREET SUITE 302 BOSTON MA 02109 MANAGEMENT SERVICES 1847540 ROPES & GRAY LLP 800 BOYLSTON STREET SUITE 3600 BOSTON MA 02199 LEGAL SERVICES 1358808 MP CARE SOLUTIONS 1120 PITTSFORD-VICTOR ROAD PITTSFORD NY 14534 MANAGEMENT SERVICES 1145716 SONNICK PARTNERS LLC 860 BROADWAY 5TH FLOOR NEW YORK NY 10003 CONSULTANT & SOFTWARE- CALL CENTER 468556 MAZARS USA LLP 135 WEST 50TH STREET NEW YORK NY 10020 CONSULTANT & BUSINESS DEVELOPMENT 319079 9 207503 1587433 1794936 MEDICAID PAYMENTS 524114 412082085 412082085 MEDICARE PAYMENTS 524114 800 800 412082885 374335 374335 18894490 19069027 -174537 -174537 -174537 0 207503 11201 -11201 -11201 OTHER REVENUE 900099 100000 100000 100000 414166418 412182885 0 188597 2145500 2145500 13259392 13259392 404476 404476 2365233 2365233 1255921 1255921 3036195 3036195 934791 934791 152455 152455 93929 93929 3713304 3713304 362666 362666 1140603 1140603 1626659 1626659 3379327 3379327 114803 114803 82175 82175 1033726 1033726 724891 724891 144136 144136 PHARMACY COST 232831583 232152299 679284 MEDICAL SERVICES 130910546 130910546 HEALTH ASSESSMENTS & SU 4982506 4982506 UTILIZATION MANAGEMENT 1998335 1998335 2156460 2156460 408849612 368045351 40804261 0 57998015 47085196 3225576 726137 172986 453027 23178219 58997394 612709 694689 4843282 3268428 2197167 1574854 17022610 19863943 265359 180269 104672641 129575509 38506645 47780608 260876 7013342 7539501 28830781 38785921 74611644 94106030 X 30060997 35469479 30060997 35469479 104672641 129575509 5316806 91676 0 X X 0 1 X 1 0 X 1240607 690094 1750106 1296667 1794936 6772410 307993102 343625076 397174076 386047352 412082885 1846922491 309233709 344315170 398924182 387344019 413877821 1853694901 0 0 0 1853694901 7010 65517 284800 256100 374335 987762 7010 65517 284800 256100 374335 987762 5870 114329 100000 220199 309240719 344380687 399214852 387714448 414352156 1854902862 0.99930 0.99960 0.00050 0.00040 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER REVENUE - 2016 AMOUNT: $ 5,870. 2017 AMOUNT: $ 114,329. 2018 AMOUNT: $ 100,000. 1047802 252802 795000 2259427 1746260 513167 1536053 1269366 266687 1574854 DEFERRED RENT 2084072 SUBVENTION PAYABLE TO 501(C) ORG. 3233652 PREMIUM PAYABLE TO CMS 13459243 DUE TO THIRD PARTY 20008954 38785921 X 414269295 91676 91676 414177619 -11201 -11201 414166418 408860813 11201 11201 408849612 0 408849612 PART X, LINE 2: THE PLAN WAS INCORPORATED AS A NOT-FOR-PROFIT CORPORATION UNDER THE LAWS OF THE STATE OF NEW YORK AND IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THEREFORE, THERE IS NO PROVISION FOR INCOME TAXES INCLUDED IN THE ACCOMPANYING FINANCIAL STATEMENTS. IN ADDITION, MANAGEMENT HAS ASSESSED WHETHER THERE WERE ANY UNCERTAIN TAX POSITIONS WHICH MAY GIVE RISE TO INCOME TAX LIABILITIES AND DETERMINED THAT THERE WERE NO SUCH MATTERS REQUIRING RECOGNITION IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE PLAN FILES INCOME TAX RETURNS IN THE U.S. FEDERAL JURISDICTION. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES -11,201. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 11,201. LIVE YOUR LIFE FUNDRAISER 207503 207503 5937 1350 3914 207503 207503 5937 1350 3914 11201 -11201 X X 0 0 0 0 0 0 0 1 0 DOUGLAS WIRTH PRESIDENT/CEO 500812 0 138000 0 552 0 33191 0 37476 0 710031 0 0 0 FELICE D KUSSOY CHIEF FINANCIAL OFFICER 244513 0 12500 0 1015 0 9364 0 16167 0 283559 0 0 0 NICHOLAS LIGUORI EXECUTIVE VICE PRESIDENT 312000 0 12500 0 360 0 8113 0 968 0 333941 0 0 0 JEROME ERNST MD CHIEF MEDICAL OFFICER 265512 0 12500 0 4944 0 9395 0 34711 0 327062 0 0 0 MAURA MCGRATH CHIEF COMPLIANCE & PRIVACY OFFICER 195210 0 12500 0 1158 0 6250 0 3764 0 218882 0 0 0 TERRY LEACH VP OF PHARMACY 226552 0 5000 0 981 0 1845 0 37645 0 272023 0 0 0 KEVIN STEFFENS VP OF HEALTH SERVICES OPERATIONS 181392 0 5000 0 372 0 9501 0 15210 0 211475 0 0 0 SALVATORE GIUNTA VP OF INFORMATION TECHNOLOGY 229064 0 5000 0 1427 0 11856 0 4028 0 251375 0 0 0 SHEILA MAGUIRE DIR. DATA GOVERNANCE SOFTWARE DEVELO 178079 0 0 0 158 0 4195 0 4704 0 187136 0 0 0 SHELLY SIMA TOUSSI MD MEDICAL DIRECTOR 235194 0 5000 0 339 0 10807 0 4028 0 255368 0 0 0 STEPHANE HOWZE VP OF MS/OMBUDSPERSON 201217 0 5000 0 305 0 11287 0 40549 0 258358 0 0 0 PART I, LINE 7 THE FOLLOWING INDIVIDUALS RECEIVED A NON-FIXED PAYMENT IN THE FORM OF A BONUS DURING 2018: DOUGLAS WIRTH - $138,000 NICHOLAS LIGUORI - $12,500 JEROME ERNST- $12,500 FELICE KUSSOY - $12,500 MAURA MCGRATH - $12,500 TERRY LEACH - $5,000 SHELLY SIMA TOUSSI- $5,000 SALVATORE GIUNTA - $5,000 STEPHANE HOWZE - $5,000 KEVIN STEFFENS - $5,000 FORM 990, PART VI, SECTION A, LINE 6 AMIDA CARE HAS TWO CLASSES OF MEMBERS OF THE ORGANIZATION: CLASS A AND CLASS B MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OF AMIDA CARE HAVE THE AUTHORITY TO APPOINT AND REMOVE BOARD MEMBERS OF THE ORGANIZATION, AND OTHER AUTHORITIES AS DELINEATED IN THE BYLAWS OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 FOR 2018 IS REVIEWED IN DETAIL BY THE ORGANIZATION'S CFO. ANY QUESTIONS ARISING FROM THAT REVIEW WILL BE DISCUSSED WITH THE PREPARER OF THE RETURN. SUBSEQUENT TO THE DETAILED CFO REVIEW, THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S CEO. ANY QUESTIONS ARISING FROM THAT REVIEW WILL BE DISCUSSED WITH THE CFO AND THE PREPARER OF THE RETURN, AS NEEDED. FOLLOWING CFO AND CEO REVIEW, THE FORM 990 IS REVIEWED BY THE BOARD OF DIRECTORS AT A REGULARLY SCHEDULED BOARD MEETING. THE CEO AND CFO WILL RESPOND TO ANY QUESTIONS RAISED BY THE BOARD MEMBERS. ONCE ALL QUESTIONS HAVE BEEN ANSWERED, THE BOARD, CEO AND CFO WILL APPROVE THE FINALIZATION AND FILING OF THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS, OFFICERS AND KEY EMPLOYEES ARE REQUIRED ANNUALLY TO COMPLETE AND SIGN A DETAILED CONFLICT OF INTEREST DISCLOSURE STATEMENT. EMPLOYEES ARE REQUIRED TO PROMPTLY DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST TO HIS OR HER SUPERVISOR (OR IN THE CASE OF THE CEO TO THE CHAIR OF THE BOARD OF DIRECTORS). MEMBERS OF THE BOARD OF DIRECTORS ARE REQUIRED TO PROMPTLY DISCLOSE ANY REAL OR POTENTIAL CONFLICTS OF INTEREST TO THE CHAIR OF THE BOARD OF DIRECTORS (OR IN THE CASE THE CONFLICT IS REPORTABLE BY THE CHAIR THEN TO THE VICE CHAIR). THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY THE CHIEF COMPLIANCE & PRIVACY OFFICER, WHO RECORDS ANY POTENTIAL CONFLICTS AND MONITORS BUSINESS RELATIONSHIPS BETWEEN AMIDA CARE AND THE INDIVIDUAL REPORTING A POTENTIAL CONFLICT OR ANY ORGANIZATION THAT INDIVIDUAL MAY BE AFFILIATED WITH THAT DOES BUSINESS WITH AMIDA CARE. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S BOARD OF DIRECTORS COMMISSIONED A CEO COMPENSATION STUDY TO ESTABLISH COMPENSATION PACKAGES FOR THE CEO. THE BOARD OF DIRECTORS CHAIR COMPLETES AN ANNUAL PERFORMANCE EVALUATION ON THE CEO AND RECOMMENDS ANY COMPENSATION ADJUSTMENTS TO THE BOARD FOR APPROVAL. THE ORGANIZATION'S CEO UTILIZES THE ASSOCIATION FOR COMMUNITY AFFILIATED PLAN ("ACAP") COMPENSATION STUDY TO ESTABLISH THE COMPENSATION OF THE MEDICAL DIRECTOR, CFO, EXECUTIVE VICE PRESIDENT AND CHIEF COMPLIANCE & PRIVACY OFFICER ("CCPO"). ACAP IS AN ASSOCIATION OF NONPROFIT MEDICAID AND MEDICARE HEALTH PLAN ORGANIZATIONS. THE ORGANIZATION'S CEO COMPLETES AN ANNUAL PERFORMANCE EVALUATION OF THE CMO, CFO, EVP AND CCPO. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES IT GOVERNING DOCUMENTS, FORM 990, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE FOR PUBLIC INSPECTION UPON WRITTEN REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A COMMITTEE RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT AS WELL AS THE SELECTION OF THE INDEPENDENT ACCOUNTANT. AIDS DAY SERVICES PLANNING INC 14 PENN PLAZA 2ND FLOOR NEW YORK NY 10122 134122125 HEALTHCARE NY 501(C)(3) LINE 10 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0