Common use of ACA PCP Payments to Capitated Plans Clause in Contracts

ACA PCP Payments to Capitated Plans. Upon the Agency’s receipt and approval of the capitated Health Plan’s ad hoc and quarterly reports of utilization and encounter data for physicians eligible for the ACA primary care physician payment increase, the Agency shall pay the Health Plan a supplemental payment for eligible services provided between January 1, 2013 and December 31, 2014. This payment will be based on the Agency’s approved health plan payment methodology from the Centers for Medicare & Medicaid Services.