Common use of Cost Neutrality Cap Clause in Contracts

Cost Neutrality Cap. The requirement that the cost of providing care to a member in CHOICES Group 2, including HCBS, home health, and private duty nursing, shall not exceed the cost of providing nursing facility services to the member, as determined in accordance with TennCare policy.

Cost Neutrality Cap. The requirement that the cost of providing care to a member in CHOICES Group 2, including HCBS, CHOICES HCBS and Medicaid reimbursed home health, health and private duty nursing, shall not exceed the cost of providing nursing facility services to the member, as determined in accordance with TennCare policy. A member’s individual cost neutrality cap shall be the average cost of Level 1 nursing facility care unless a higher cost neutrality cap is established by TENNCARE based on information submitted by the AAAD or MCO (as applicable) in the level of care application.