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 U.S. House legislation “Further Consolidated Appropriations Act, 2020” repealed the HIF for calendar years beginning after December 31, 20204. 4 xxxxx://xxxx.xxxxx.xxx/billsthisweek/20191216/BILLS-116HR1865SA-RCP116-44.PDF
CARE MANAGEMENT COSTS. The development of the actuarially sound capitation rates for July 2017 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 2017 includes administrative expense assumptions consistent with the values included in the Original certification. State Taxes and Fees Effective July 1, 2017, the Sales and Use tax will no longer be applicable to the MyCare population. This tax will be replaced by the HIC Franchise Fee. 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 for July 2017 includes HIC Franchise Fee (collected by ODM) and HIC tax components (collected by the Ohio Department of Insurance). Applicable amounts for the Sales and Use tax have been excluded from the capitation rates. HIC Franchise Fee amounts were developed by MCOP based on projected Medicaid member months, and then weighted based on regional enrollment by MCOP. The HIC tax will remain at 1% of total capitation. Health Insurer Provider Fee (HIPF) Consistent with the Original certification, we anticipate that adjustments will be made to the July 2017 capitation rates based on HIPF amounts collected in CY 2018 attributable to 2017 net premiums.
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.
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.
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.
