Annual Reconciliation Payment Sample Clauses

Annual Reconciliation Payment. Each hospital’s interim quarterly payments will be reconciled to its filed Medicare cost reports for the spending year in which CPE payments were made. If, at the end of the annual reconciliation process, it is determined that expenditures claimed were overstated or understated, the overpayment or underpayment will be properly credited/debited to the federal government. The annual reconciliation payment is based on the recalculation of inpatient and outpatient program costs using the cost center per diems and cost-to-charge ratios derived from its filed Medicare cost report for the service period. Days, charges and payments for Medicaid FFS services originating from the provider’s auditable records will be reconciled to MMIS paid claims records. Medicaid managed care and uninsured days, charges and payments will originate from the provider’s auditable records. For each inpatient hospital routine cost center, a per diem is calculated by dividing total costs of the cost center (from ws B, Part I, column 25) by total days of the cost center (from ws S-3, Part I, column 6). For each ancillary hospital cost center, a cost to charge ratio is calculated by dividing the total costs of the cost center (from ws B, Part I, column 25) by the total charges of the cost center (from ws C, Part I, column 8). The Adult and Pediatric (A&P) routine per diem, in accordance with CMS-2552 worksheet D-1, should be computed by including observation bed days in the total A&P patient day count and excluding swing bed nursing facility costs and non medically necessary private room differential costs from the A&P costs. For inpatient UCC cost computation, each routine hospital cost center per diem is multiplied by the cost center’s number of eligible UCC days, and each ancillary hospital cost center’s cost-to­ charge ratio is multiplied by the cost center’s UCC-eligible inpatient charges. Eligible UCC days and charges pertain only to the UCC populations and services as defined in the STCs and exclude any non-hospital services such as physician/practitioner professional services. The sum of each cost center’s inpatient hospital UCC cost is the hospital’s inpatient UCC cost prior to the application of payment/revenue offsets and an appropriate adjustment of one percent to remove the unallowable cost of services to undocumented aliens. For outpatient UCC cost computation, each ancillary hospital cost center cost-to-charge ratio is multiplied by the cost center’s UCC-eligible outpatient ...

Annual Reconciliation Payment. (A) On or before 1 April in each Contract Year, Electrabel shall prepare and submit to NuclearSub an annual reconciliation statement which sets out for the preceding Contract Year (“Annual Reconciliation Payment Statement”): (i) the Annual O&M Services Fee Reconciliation Payment (including the constituent elements of the calculation of that amount as set out at 9.7(A) together with reasonable supporting evidence of each relevant category of Cost set out in the Assumption Book which comprises the O&M Services Fees Incurred) which, for the avoidance of doubt, may be a positive or a negative amount; (ii) the O&M Costs Overrun Payment (if any) payable by Electrabel (including the constituent elements of the calculation of that amount and reasonable supporting evidence for such constituent elements); (iii) any amounts payable by Electrabel under Clause 9.6(A) or Clause 9.6(B) (“Disallowed Costs Reimbursement Amounts”); (iv) any Availability Damages payable by Electrabel in accordance with Clause 17.1(A); (v) any Minimum Payment Margin Reimbursement Amount payable by Electrabel in accordance with Clause 17.3(C); (vi) any Subcontractor Delay LDs and/or Net Recovered Amount and/or Subcontractor Indemnity Amounts payable by Electrabel under Clause 7.5(B) and/or Net Proceeds Amount payable by Electrabel under Clause 16.5; (vii) the LTO Waste VAF Reconciliation Payment payable by Electrabel (in which case, it will be a positive figure) or NuclearSub (in which case it will be a negative figure) (as applicable) under Clause 9.10(D); (viii) any New LTO Spare Parts Reconciliation Payment payable by NuclearSub under Clause 5.2(E); and (ix) the net amount to be paid by Electrabel to NuclearSub or by NuclearSub to Electrabel (as applicable) being the aggregate amount of (i) to (vii) (inclusive) less (viii) (the “Annual Reconciliation Payment”). (B) If the Annual Reconciliation Payment is a positive amount, Electrabel shall pay the Annual Reconciliation Payment to NuclearSub. If the Annual Reconciliation Payment is a negative amount, NuclearSub shall pay the Annual Reconciliation Payment to Electrabel. (C) NuclearSub or Electrabel (as applicable) shall pay the undisputed portion of the Annual Reconciliation Payment for the relevant Contract Year to Electrabel or NuclearSub (as applicable) no later than twenty (20) Business Days after the date of submission of the Annual Reconciliation Payment Statement. (D) If an amount in the Annual Reconciliation Payment Statement or a Mon...