OFFICIAL l y a DOCUMENTS THE WORLD BANK Bouchard 547, 29th floor Tel.: (54-11) 4316-9700 /44 IBRD * IDA I WORLDBANKOROUP C1106ABG Fax: (54-11) 4313-1233 Latin America & the Caribbean aeAut6nornade Buenos Aires OooDeln-bcs fo(A Arenieleubi August 28, 2015 His Excellency Axel Kicillof Minister of Economy and Public Finance Ministry of Economy and Public Finance Hip6lito Yrigoyen 250 1310 Buenos Aires, Argentina Re: ARGENTINA: Loan No. 8062-AR (Provincial Public Health Insurance Development Project) - Amendment to the Loan Agreement Excellency: We refer to the Loan Agreement between the Argentine Republic (the Borrower) and the International Bank for Reconstruction and Development (the Bank), dated August 6, 2012 (the Loan Agreement) for the above-captioned Project. Please note that capitalized terms used in this letter ("Amendment Letter") and not defined herein have the meaning ascribed to them in the Loan Agreement. As a result of our recent conversations on the subject, the Bank hereby proposes to amend the Loan Agreement, as follows: 1. Parts B. 1 (a) and (b) of Schedule 1 to the Loan Agreement are hereby amended in their entirety to read as follows: "1. Improving the management capacity of the MSN and the MSPs by: (a) developing integrated information systems, instruments, and capacity to manage the PHIP, including administrative and billing data systems and the promotion of electronic medical records, the preparation and execution of annual performance agreements between MSN and MSPs, and between MSPs and Authorized Providers and new contracts and payment systems; (b) carrying out of outreach and service delivery strategies for rural and indigenous peoples (including the promotion of communities' participation, user rights, and culturally appropriate services for the inclusion of indigenous populations) and strengthening the health workforce skills of health staff in rural areas;" 2 2. Parts B. 1 (e) and (f) of Schedule 1 to the Loan Agreement are hereby amended in their entirety to read as follows: "(e) carrying out of studies on health system financing and related mechanisms, including mechanisms for integrating other public health programs with insurance/capitation schemes into the PHIP, all aimed at facilitating policy-making decisions of MSN and MSPs related with achieving effective universal health coverage; and (f) improving MSN's and MSP's communication strategies for disseminating information about health plans, changing behavior among health sector staff, and promoting social participation; and" 3. Part B.2 of Schedule 1 to the Loan Agreement is hereby amended in its entirety to read as follows: "2. Supporting management, monitoring and evaluation capacities of the PCU, UFI-S and PHIUs, through the provision of technical assistance (including the financing of Operating Costs and Training), and the carrying out of monitoring and evaluation, and financial and technical audits under the Project." 4. The table in Section IV.A.2 of Schedule 2 to the Loan Agreement is hereby amended to read in its entirety as set forth in Attachment I to this Amendment Letter. 5. Section IV.B.2 of Schedule 2 to the Loan Agreement is hereby amended to read in its entirety as follows: "The Closing Date is September 30, 2017." All other provisions of the Loan Agreement, except as amended herein, shall remain in full force and effect. 3 Please confirm your agreement with the foregoing, on behalf of the Borrower, by signing and dating two originals of this Amendment Letter and returning one fully signed original to us. The amendment set forth in this Amendment Letter will become effective as of July 1, 2015, upon receipt by the Bank of one fully executed original of this Amendment Letter. Very truly yours, INTERNATIONAL BANK FOR RECONSTRUCTION AND DEVELOPMENT By_IA& . sko Hentschel Director Argentini, Paraguay and Uruguay Latin America and the Caribbean Region AGREED AND IRME ARGENTINE U LIC By: (Auth ri ed Representa 1 Name: Title: Date: 3 OCT 20 AUERDO MEyFP No 130/15 4 Attachment I Amount of the Loan Percentage of Expenditures Allocated to be financed Categonv - epesd in USD) (inclusive of Taxes) (1) Goods 50,000,000 85% (2) Consultants' services 53,000,000 100% (including technical audits), Non-consultant Services and Training Under Nomenclador Unico-A: 100% until December 31, 2012; 85% until December 31, 2013; 65% until December 31, (3) Capitation Payments 275,000,000 2014; 60% until June 30, under Part A.1(a) of the 2015 and 70% thereafter Project Under Nomenclador Unico-B, starting on January 1, 2013 (as per Section B. 1.(c) below): 85% until December 31, 2013; 65% until December 31, 2014; 60% until June 30, 2015 and 70% thereafter (4) Capitation Payments 15,000,000 60% as per Section B.1 (d) under Part A. 1(b) of the below Project (5) Operating Costs 6,000,000 100% (6) Front-end Fee 1,000,000 Amount payable pursuant to Section 2.03 of this Agreement in accordance with Section 2.07 (b) of the General Conditions (7) Interest Rate Cap or Amount due pursuant to Interest Rate Collar 0 Section 2.07(c) of this premium Agreement IL TOTAL AMOUNT 400,000,000 5 cc: Mr. Alejandro Foxley, Executive Director for Argentina, the World Bank Mr. Daniel Kostzer, Alternate Executive Director for Argentina, the World Bank Mr. Daniel Gollan, Minister of Health, Ministry of Health of Argentina. Mr. Federico Kaski Fullone, Ministry of Health of Argentina Mr. Nicolas Kreplac, Ministry of Health of Argentina Mr. Martin Sabignoso, Project Coordinator, Plan Sumar Mr. Jose Priegue, General Coordinator, Ministry of Health of Argentina