CARE MANAGEMENT COSTS Sample Clauses

CARE MANAGEMENT COSTS. The development of the actuarially sound capitation rates for July 2020 includes care management assumptions consistent with the values included in the Original certification. ADMINISTRATIVE EXPENSE COST ALLOWANCE The development of the actuarially sound capitation rates for July 2020 includes administrative expense assumptions consistent with the percentage of the capitation rates included in the Original certification. STATE TAXES AND FEES Fees and Taxes are loaded to the capitation rates after the application of non-benefit expenses. This includes the Health Insuring Corporation (HIC) Franchise Fee along with the HIC tax. The HIC Franchise Fee consists of a PMPM amount that varies based on an entity’s Medicaid member months. The development of the actuarially sound capitation rates includes HIC Franchise Fee (collected by ODM) and HIC tax (collected by the Ohio Department of Insurance) components. HIC Franchise Fee amounts were developed by MCOP based on projected Medicaid member months for July through December 2020, and then weighted based on regional enrollment by MCOP. As the HIC Franchise Fee is assessed on a state fiscal year basis, the July Amendment to the CY 2020 capitation rates reflects HIC Franchise Fee amounts applicable from July through December 2020. The HIC tax will remain at 1% of total capitation. HEALTH INSURANCE PROVIDERS FEE (HIF) In the Original certification, we anticipated the capitation rates would be adjusted based on HIF amounts collected in CY 2021 that are attributable to 2020 net premiums. As of this rate amendment, we no longer expect to adjust the capitation rates for HIF amounts collected in CY 2021. U.S. House legislation “Further Consolidated Appropriations Act, 2020” repealed the HIF for calendar years beginning after December 31, 20204. 4 xxxxx://xxxx.xxxxx.xxx/billsthisweek/20191216/BILLS-116HR1865SA-RCP116-44.PDF
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CARE MANAGEMENT COSTS. The development of the actuarially sound capitation rates for July 2019 includes care management assumptions consistent with the values included in the Original certification. ADMINISTRATIVE EXPENSE COST ALLOWANCE The development of the actuarially sound capitation rates for July 2019 includes administrative expense assumptions consistent with the percentage of the capitation rates included in the Original certification. STATE TAXES AND FEES Fees and Taxes are loaded to the capitation rates after the application of non-benefit expenses. This includes the Health Insuring Corporation (HIC) Franchise Fee along with the HIC tax. The HIC Franchise Fee consists of a PMPM amount that varies based on an entity’s Medicaid member months. The development of the actuarially sound capitation rates includes HIC Franchise Fee (collected by ODM) and HIC tax (collected by the Ohio Department of Insurance) components. HIC Franchise Fee amounts were developed by MCOP based on projected Medicaid member months, and then weighted based on regional enrollment by MCOP. As the HIC Franchise Fee is assessed on a state fiscal year basis, the July Amendment to the CY 2019 capitation rates reflects HIC Franchise Fee amounts applicable from July through December 2019. The HIC tax will remain at 1% of total capitation.
Sample 1
CARE MANAGEMENT COSTS. The development of the November 2021 capitation rates includes care management assumptions consistent with the values included in the Original certification. ADMINISTRATIVE EXPENSE COST ALLOWANCE The development of the November 2021 capitation rates includes administrative expense assumptions consistent with the percentage of the capitation rates included in the Original certification. STATE TAXES AND FEES Fees and Taxes are loaded to the capitation rates after the application of non-benefit expenses. This includes the Health Insuring Corporation (HIC) Franchise Fee along with the HIC tax. As the HIC Franchise Fee is assessed on a state fiscal year (SFY) basis, the November 2021 rate amendment is consistent with the CY 2021 capitation amendment HIC Franchise Fee amounts for rates effective July 1, 2021. The HIC tax will remain at 1% of total capitation.
Sample 1
CARE MANAGEMENT COSTS. The development of the amended CY 2021 capitation rates includes care management assumptions consistent with the values included in the Original certification. ADMINISTRATIVE EXPENSE COST ALLOWANCE The development of the amended CY 2021 capitation rates includes administrative expense assumptions consistent with the percentage of the capitation rates included in the Original certification. STATE TAXES AND FEES Fees and Taxes are loaded to the capitation rates after the application of non-benefit expenses. This includes the Health Insuring Corporation (HIC) Franchise Fee along with the HIC tax. The HIC Franchise Fee consists of a PMPM amount that varies based on an entity’s Medicaid member months. The development of the actuarially sound capitation rates includes HIC Franchise Fee (collected by ODM) and HIC tax (collected by the Ohio Department of Insurance) components. HIC Franchise Fee amounts were developed by MCOP based on projected Medicaid member months for January through June 2021, and July through December 2021, and then weighted based on regional enrollment by MCOP. As the HIC Franchise Fee is assessed on a state fiscal year basis, we estimated separate HIC franchise fee amounts for the January through June and July through December effective rates. The HIC tax will remain at 1% of total capitation.
Sample 1
CARE MANAGEMENT COSTS. Effective July 1, 2022 ODM anticipates increasing the reimbursement for AAA waiver service coordination by 4% over the reimbursement included in the Original certification. This reimbursement increase was included in the development of non-benefit expense for the impacted populations. ADMINISTRATIVE EXPENSE COST ALLOWANCE The development of the July 2022 capitation rates includes administrative expense assumptions consistent with the percentage of the capitation rates included in the Original certification. STATE TAXES AND FEES Fees and Taxes are loaded to the capitation rates after the application of non-benefit expenses. This includes the Health Insuring Corporation (HIC) Franchise Fee along with the HIC tax. The HIC Franchise Fee consists of a PMPM amount that varies based on an entity’s Medicaid member months. The development of the actuarially sound capitation rates includes HIC Franchise Fee (collected by ODM) and HIC tax (collected by the Ohio Department of Insurance) components. HIC Franchise Fee amounts were developed by MCOP based on projected Medicaid member months for July through December 2022, and then weighted based on regional enrollment by MCOP. As the HIC Franchise Fee is assessed on a state fiscal year basis, we estimated separate HIC franchise fee amounts for the January through June and July through December effective rates. The HIC tax will remain at 1% of total capitation.
Sample 1

Related to CARE MANAGEMENT COSTS

  • Default – Reprocurement Costs In case of Contract breach by Contractor, resulting in termination by the County, the County may procure the goods and/or services from other sources. If the cost for those goods and/or services is higher than under the terms of the existing Contract, Contractor will be responsible for paying the County the difference between the Contract cost and the price paid, and the County may deduct this cost from any unpaid balance due the Contractor. The price paid by the County shall be the prevailing market price at the time such purchase is made. This is in addition to any other remedies available under this Contract and under law.

  • FUNERAL EXPENSES The City shall expend a sum of money not to exceed $30,000 for funeral expenses to the heirs of any Unit member who dies while on active duty from injuries incurred while performing his/her job or who dies as a direct cause of such injuries. This amount includes any amount already available for this purpose in accordance with California State Labor Code Section 4701.

  • General Expenses You authorize the Manager to charge your account with your Underwriting Percentage of all expenses of a general nature incurred by the Manager and Co-Managers under the applicable AAU in connection with the Offering, including the negotiation and preparation thereof, or in connection with the purchase, carrying, marketing and sale of any securities under the applicable AAU and any Intersyndicate Agreement, including, without limitation, legal fees and expenses, transfer taxes, costs associated with approval of the Offering by the NASD and the costs of currency transactions (including forward and hedging currency transactions) entered into to facilitate settlement of the purchase of Securities permitted under Section 3.1 hereof.

  • Travel-related Expenses Vendor agrees to comply with Citizens’ then-current Vendor Travel Reimbursement Guidelines. All travel-related expenses must be pre-approved in writing by Citizens’ Contract Manager or designee. Citizens shall reimburse Vendor for pre-approved travel-related expenses incurred in the performance of Services following Citizens’ receipt of Vendor’s reimbursement request submitted in accordance with the then-current Vendor Travel Reimbursement Guidelines.

  • Child Care Expenses (a) Where an employee is requested or required by the Employer to attend:

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