Budget Neutrality Sample Clauses

Budget Neutrality. Utilization
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Budget Neutrality. 1. Please complete the budget neutrality workbook. 2. Discuss any variance noted to the estimated budget, including reasons for variance in enrollment and/or in total costs, and/or in per enrollee costs. Describe any plans to mitigate any overages in budget neutrality by the end of the demonstration period.
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Budget Neutrality. This subsidy program will be subject to the budget neutrality limit specified in STC 113.
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Budget Neutrality. CCO Payment Rates will be retroactively risk-adjusted in a budget- neutral manner, starting from statewide base data, to reflect each CCO’s membership and its impact on risk scores across and within rate setting regions.
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Budget Neutrality. ‌ In accordance with 42 CFR § 438.5(g), risk adjustment will be applied in a budget neutral manner. I.6.B. Appropriate Documentation‌ I.6.B.i. Prospective Risk Adjustment‌ I.6.B.i.(a) Data and Data Adjustments‌ Encounter and member data are used for the risk adjustment factors. AHCCCS regularly performs testing on encounters to identify any potential areas of concern. If AHCCCS identifies any encounter gaps, AHCCCS contacts the Contractor and works with them to improve encounter submissions. AHCCCS monitors the encounters by reviewing encounter data by date of service and form type to identify potential issues. The results of these analyses assist in determining if any encounter data is deemed unusable for the risk adjustment process and if any adjustments to the encounter data are required. I.6.B.i.(b) Model and Model Adjustments‌ AHCCCS is using risk scores resulting from the Combined Chronic Illness and Disability Payment System and Medicaid Rx (CDPS+Rx) Version 7.0 prospective risk adjustment model. CDPS+Rx is developed by the University of California, San Diego, to assign the condition markers to each enrollee based on a combination of the diagnoses and National Drug Code (NDC) data. The CDPS+Rx model assigns one or more of the condition-based categories based on diagnostic and procedural information available on medical and pharmacy claims, as well as demographic categories based on age and gender. A relative health status weight is associated with each age, gender, and condition category. The weights used in the prospective risk adjustment model were calibrated to be Arizona state specific for the ACC and ACC-RBHA Program using a Marker Study Period of August 2021 through July 2022 and Cost Relativity Period of August 2022 through July 2023. The following costs were not reflected in the condition or demographic weights in the calibrated AHCCCS risk adjustment model: • Costs above reinsurance thresholds for which the Contractors were not at risk • Maternity costs covered by the Delivery Supplement payment The diagnosis codes on all encounters, except all laboratory and radiology codes, are used for purposes of identifying conditions, but the costs not at risk (identified above) were excluded for purposes of determining the risk weights. This process captures the additional complexity/cost for at-risk conditions due to the presence of an underlying not-at-risk condition. The AHCCCS risk adjustment model combines CDPS+Rx version 7.0 with social determi...
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Budget Neutrality. ‌ The model is budget neutral in accordance with 42 CFR § 438.5(g). The budget neutrality adjustment is the last step to calculate the final risk adjustment factor. To calculate the final risk adjustment factor, the relative risk score is divided by the budget neutrality adjustment for each risk group and GSA. The budget neutrality adjustment is calculated by taking the rating period capitation rates before risk adjustment times the rating period member months and dividing by the rating period capitation rates times the relative risk score times the rating period member months. 1 For comparable statistics of other risk adjustment models in the industry, please refer to the Society of Actuaries 2016 research report titled “Accuracy of Claims-Based Risk Scoring Models “, Table 4.2.2: R-Squared and MAE, Prospective Models, available at: xxxxx://xxx.xxx.xxx/globalassets/assets/Files/Research/research-2016- accuracy-claims-based-risk-scoring-models.pdf I.7. Acuity Adjustments‌ I.7.A. Rate Development Standards‌ This section of the 2025 Guide provides information on acuity adjustments which account for significant uncertainty about the health status or risk of a population, which are permissible adjustments to the capitation rates under 42 CFR § 438.5(f). I.7.B. Appropriate Documentation‌
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Budget Neutrality 
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Related to Budget Neutrality

  • Occupational Health and Safety Committee ‌ (a) The parties agree that a joint occupational health and safety committee will be established. The Committee shall govern itself in accordance with the provisions of the Occupational Health and Safety Regulations made pursuant to the Workers Compensation Act. The Committee shall be between the Employer and the Union, with equal representation, and with each party appointing its own representatives. The Union agrees to actively pursue with the other Health Care unions, where more than one union is certified with the Employer, a joint union/employer committee for the purposes of the Occupational Health and Safety Regulations. (b) Employees who are members of the Committee shall be granted leave without loss of pay or receive straight-time regular wages while attending meetings of the Joint Committee. Employees who are members of the Committee shall be granted leave without loss of pay or receive straight-time regular wages to participate in joint workplace inspections and joint accident investigations at the request of the Committee pursuant to the WCB Occupational Health and Safety Regulations. Committee meetings, workplace inspections and accident investigations shall be scheduled during normal working hours whenever practicable. (c) The Occupational Health and Safety Committee shall have as part of its mandate the jurisdiction to receive complaints or concerns regarding workload problems which are safety-related, the right to investigate such complaints, the right to define the problem and the right to make recommendations for a solution. Where the Committee determines that a safety-related workload problem exists, it shall inform the Employer. Within 21 days thereafter, the Employer shall advise the Committee what steps it has taken or proposes to take to rectify the safety-related workload problem identified by the Committee. If the Union is not satisfied with the Employer's response, it may refer the matter to the Industry Trouble shooter for a written recommendation. (d) No employee shall be disciplined for refusal to work when excused by the provisions of the

  • Health and Safety Committee 24.01 The Employer and the Union agree that they mutually desire to maintain standards of safety and health in the home, in order to prevent injury and illness. 24.02 A joint management and employees health and safety committee shall be constituted with representation of at least half by employees from the bargaining unit and of employees who are not represented by the union, which shall identify potential dangers, recommended means of improving the health and safety programs and obtaining information from the Employer or other persons respecting the identification of hazards and standards elsewhere. The committee shall normally meet at least once a month. Scheduled time spent in such meetings is to be considered time worked. Minutes shall be taken of all meetings and copies shall be sent to the Employer and to the Union. 24.03 Two representatives of the joint health and safety committee, one from management and one from the employees on a rotating basis designated by the employees, shall make monthly inspections of the work place and equipment and shall report to the health and safety committee the results of their inspection. In the event of accident or injury, such representatives shall be notified immediately and shall investigate and report as soon as possible to the committee and to the Employer on the nature and causes of the accident or injury. Furthermore, such representatives must be notified of the inspection of a government inspector and shall have the right to accompany him on his inspections. Scheduled time spent in all such activities shall be considered as time worked. 24.04 The Joint Health and Safety Committee and the representa- tives thereof shall have reasonable access to the annual summary of data from The Workers' Compensation Board relating to the number of work accident fatalities, the number of lost workday cases, the number of lost workdays, the number of non-fatal cases that required medical aid without lost workdays, the incidence of occupational injuries, and such other data, as The Workers' Compensation Board may decide to disclose. 24.05 The Union agrees to endeavour to obtain the full co- operation of its membership in the observation of all safety rules and practices. Employees on the premises are required to respond to the Retirement Residence fire alarm by proceeding directly to their appointed post. Failing to do so may result in disciplinary action. 24.06 The Employer will use its best efforts to make all affected direct care employees aware of residents who have serious infectious diseases. The nature of the disease need not be disclosed. Employees who are not direct care employees will be made aware of special procedures required of them to deal with these circumstances. The parties agree that all employees are aware of the requirement to practice universal precautions in all circumstances.

  • Joint Health and Safety Committee (a) The Employer and the Union agree that they mutually desire to maintain standards of occupational health and safety in the organization, in order to prevent accidents, injury and illness. The parties agree to promote health and safety throughout the organization. The employer shall provide orientation and training in health and safety to new and current employees on an ongoing basis, and employees shall attend required health and safety training sessions. (b) Recognizing its responsibilities under the applicable legislation, the Employer agrees to accept as a member of its Joint Health and Safety Committee, at least one representative from the bargaining unit. The number of committee members will be no less than that determined by legislation and the bargaining unit will be entitled to the same membership as any other employee group on the committees. The Union shall notify the employer of their representatives. (c) Such Committee shall identify potential dangers and hazards, institute means of improving health and safety programs, and recommend actions to be taken to improve conditions related to occupational health and safety. (d) The Employer agrees to cooperate reasonably in providing necessary information to enable the Committee to fulfill its functions. The Committee shall respect the confidentiality of the information. (e) The Union agrees to endeavour to obtain the full cooperation of its membership in the observation of all safety rules and practices. (f) Meetings shall be held every third month or more frequently at the call of either co-chair, if required. The Committee shall keep Minutes of all meetings and make the Minutes available for review. (g) All time spent by a member of the Joint Health and Safety Committee attending meetings of the Committee and carrying out the members duties, shall be deemed to be time worked for which the member shall be paid by the Employer at the member's applicable rate of pay, and the member shall be entitled to such time from the member's work as necessary for those duties. (h) The employer shall take every precaution reasonable in the circumstances for the protection of a worker. [Occupational Health and Safety Act, s. 25

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