Calculation of Rates. The Capitation Rates are established in accordance with 42 C.F.R. 438. The Capitation Rates are attached as Appendix A “Capitation Payment Rates” and shall be deemed incorporated into this Contract and shall be binding to the Contractor and the Department, subject to CMS’ approval. If CMS fails to approve any component of the rates, the Capitation Payment rates shall be adjusted to reflect that disapproval or failure to approve. DMS will work with its actuaries to develop and certify new rates to CMS for approval. Those new rates, shall be reconciled retroactively to the beginning of the rate period certified to CMS.
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