OFFICIAL DOCUMENTS THE WORLD BANK IBRD * IDA I WORLD BANKGROUP CARLOS PINERUA Country Manager, Poland Europe and Central Asia June 30, 2017 Mr. Maciej Milkowski Vice President National Health Fund ul. Gr6jecka 186 str 02-390 Warsaw, Poland Dear Mr. Milkowski, Re: Reimbursable Advisory Services (RAS)for the National Health Fund of Poland - Amendment No. 2 to the RAS Agreement (P153244) Please refer to the Reimbursable Advisory Services Agreement between the National Health Fund ("Client") and the International Bank for Reconstruction and Development ("World Bank"), dated November 30, 2015 ("RAS Agreement"), as amended, for the Client's health sector services delivery reform including better integration of health care services. The capitalized terms used in this letter ("Amendment Letter") and not defined herein have the meaning ascribed to them in the RAS Agreement. We also refer to the Recipient's letter dated June 20, 2017 requesting to extend the RAS Agreement to October 31, 2017 with additional actikties and outputs equivalent to fifty thousand Polish Zlotys (PLN 50,000). We are pleased to inform you that the World Bank agrees to the Recipient's request, and proposes to amend the RAS Agreement as follows: 1. Section 4 of the RAS Agreement is amended to read as follows: "4. Payment (a) The Client shall pay the Bank a fixed fee of three million four hundred and sixteen thousand Polish Zlotys) (PLN 3,416,000) in accordance with the following schedule of payment: Amount of Installment Event upon which Payment is Due in Polish Zlotys (PLN) 1. PLN 841,500 within 14 days of the date of signature of this Agreement 2. PLN 1,683,000 upon approval by the Client of the final report referred to as 53 Emili Plater Street, Financial Center, 9th floor, Warsaw, Poland Tel: + 48-22 520-80-00; Fax: + 48-22 520-80-01 Mr. Maciej Milkowski -2- June 30, 2017 Amount of Installment Event upon which Payment is Due in Polish Zlotys (PLN) Output 1 and inception report referred to as Output 2 in the table under Section B of the Schedule to this Agreement 3. PLN 841,500 upon approval by to the Client of the final report referred to as Output 3 in the table under Section B of the Schedule to this Agreement 4. PLN 50,000 upon approval by to the Client of the draft interactive report referred to as Output 4 (b) in the table under Section B of the Schedule to this Agreement" 2. Section 6 of the RAS Agreement is amended to read as follows: "6. Expiration. This Agreement shall expire on October 31, 2017 unless it shall earlier be renewed with the mutual agreement of the Client and the Bank." 3. Section A.3, Component C of the Schedule to the RAS Agreement is amended to read as follows: "3. Component C: Capacity Building and Dissemination The Government will be responsible for the implementation of the ICO pilots and reforms and plans to adopt an actively participatory approach to make the policy design a joint process. The national experts included in the PST are expected to lead the implementation phase of the ICO pilots technically with the technical support of the Bank experts who will help identify technical content of the meetings and facilitate discussions, and reflect the conclusions in the review reports and pilot design in Components A and B above, respectively. To this effect, the PST meetings will be synchronized with the systematic reviews and pilot design process under Components A and B above to provide real time inputs to the Bank team. In addition to the PST meetings, NFZ will organize national conferences with wider audiences meetings/conferences about three times annually. The Bank will assist NFZ contribute to the programs of those conferences, update the status of the reviews and pilot design, and prepare technical findings and policy recommendations. Study tours to five selected countries representing different ICO modalities will be organized as part of the learning process. The Bank will recommend the candidate countries and programs, contact the host countries or programs, and propose a technical program for the visit. The study tours will be financed by the Client, and the cost is not part of the fee under Section 4 of the Agreement except for Bank staff travel cost. (a) Summary of activities to be conducted by the Bank: Activity 1: Technically facilitate PST meetings. Activity 2: Propose technical contents to the PST meetings. Activity 3: Assist the NFZ in the preparation and participate in the national conferences on the IDS reform organized by NFZ Activity 4: Design and facilitate the technical program of the study tours The Bank will prepare the following deliverables: Participation and technical coordination of the meetings of the PSTs; technical materials (PPT presentation, draft reviews, etc.) for the PST meetings; proposed technical programs of the study tours; technical contribution to the information. Mr. Maciej Milkowski -3- June 30, 2017 (b) Summary of activities to be conducted by the Bank: Develop an interactive report for the modern primary health care facility management incorporating the needs of the integrated care model 1 including: scope of primary health care services, cooperation among specialists and patients, telemedicine, prevention and education. The Bank will prepare the following deliverable: Interactive report with recommendations on: (i) management of the model 1 finance, human resources and facilities; (ii) quality assurance; (iii) reporting and data analyses; and (iv) cooperation among specialists and patients." 4. The Timetable under Section B of the Schedule to the RAS Agreement is amended to read as follows: "B. Timetable. Except as the Client and the Bank may otherwise agree, the Bank will perform the Reimbursable Advisory Services in accordance with the following tentative timetable: Outputs Tentative Timetable Component A: 1. Review report of the key domains of the IDS. April 2016 Component B: 2. Inception report presenting the ICO pilot design and June 2016 implementation models. 3. Final report with the models for the pilot design May 31, 2017 Component C: 4. (a) Participation and technical coordination of the Throughout project meetings of the PSTs; technical materials (PPT period (November presentation, draft reviews, etc.) for the PST 2015 to October meetings; proposed technical programs of the study 2017) tours; technical contribution to the information materials produced by the NFZ; and presentations during the PSTs meetings and national workshops and conference organized by the NFZ (maximum of 3 per year). (b) Interactive report with recommendations on: (i) June to October management of the model 1 finance, human resources 2017" and facilities; (ii) quality assurance; (iii) reporting and data analyses; and (iv) cooperation among specialists and patients. All the terms and conditions of the RAS Agreement, as amended hereby, shall remain in full force and effect. Mr. Maciej Milkowski -4- June 30, 2017 Please confirm the Client's agreement to the amendment by signing and dating this Amendment Letter in the spaces provided below. All other provisions of the RAS Agreement, except as amended through this Amendment Letter, shall remain in full force and effect. This Amendment Letter shall be executed in two (2) counterparts each of which shall be an original. The provisions set forth in this Amendment Letter shall become effective upon the date of the countersignature and receipt by the World Bank of one fully executed original of this Amendment Letter. Very truly yours, INTERNATIONAL BANK FOR RECONSTRUCTION AND DEVELOPMENT Carlos Pifier6a Country Manager, Poland Europe and Central Asia AGREED: NATIONAL HEALTH FUND OF POLAND Name: [_LM uIthoriz64resenttive arodowego Funduszu Zdrowia Title: Z-ca Prezesa ds. Finansowych Date: Acie Milkowsk017 -06- 3 0