Common use of Capitation Payment Rates Clause in Contracts

Capitation Payment Rates. The Capitation Payment Rate is equal to the Risk Adjusted Rate. The Department will pay the sum of the applicable monthly Capitation Payment Rate plus the ACA Rate Supplement to the PH-MCO for each Member enrolled in the PH-MCO’s program. This amount will be the payment for each month the MCO Plan Factor remains at 0.971. As each recalculation of the MCO Plan Factor occurs, the PH-MCO will be paid a revised Capitation Payment Rate in effect for each month that each TANF Philadelphia Member is enrolled in the PH-MCO’s program. In addition, the Department will, when specified by this Agreement, pay applicable Pay For performance amounts; and the applicable Maternity Care Payments; and any amounts that are owed in accordance with the Risk Sharing provisions as defined in the Home Nursing Risk Sharing Arrangement(s) of this Agreement; and any amounts that are owed in accordance with Appendix 3k, High Cost Risk Pool, of this Agreement.