Common use of Acceptance of State Clause in Contracts

Acceptance of State. Capitation Payments Contractor shall be capitated for all in-plan services, as described in Section 2.6 of this Agreement, in the amount as specified in Attachment E, and such reimbursement shall be subject to all conditions specified in this Agreement. The monthly capitation rates set forth in Attachment E shall not be subject to change during the effective period therein specified except: (1) by Federal or State law; or (2) to cover additional services not currently included in Attachment A or to reflect a reduction in covered services; or unless such change has been negotiated in accordance with Section 3.3 of this Agreement. Such change in rates shall not be effective until agreed upon in writing by the parties or, in the event of a change due to (1) above, until prior written notice by the State to the Contractor. The State shall make Capitation Payments to Contractor on a monthly basis via electronic funds transfer in the following manner: • For members on or before the last day of every month, Contractor shall receive a roster of individuals projected to be enrolled in or assigned to Contractor for the following month. • For members on or before the fifth (5th) calendar day of every month, Contractor shall receive capitation payments for individuals projected to be enrolled or assigned to Contractor for that month, based on the roster provided at the end of the preceding month (see above). These payments shall reimburse Contractor for services rendered to these individuals during that month. Contractor agrees to accept enrollment information and capitation payments in this manner and shall have written policies and procedures for receiving and processing capitation payments. Notwithstanding any other provision of this agreement, the State shall, beginning the second contract period commencing July 1, 2021 and continuing each contract period thereafter, establish age band specific capitation rates so as to equitably reflect the distribution of enrollees among the RIte Smiles program participating plans. The State will utilize encounter data from the participating plans in the rate setting process.