Common use of Managed Care Requirements Clause in Contracts

Managed Care Requirements. The state must comply with the managed care regulations published at 42 CFR 438. Capitation rates shall be developed and certified as actuarially sound, in accordance with 42 CFR 438.6. The certification shall identify historical utilization of state plan and HCBS services used in the rate development process.

Appears in 3 contracts

Samples: www.medicaid.gov, clpc.ucsf.edu, kancare.ks.gov

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Managed Care Requirements. The state must comply with the managed care regulations published at 42 CFR §438, except as waived herein. Capitation rates shall be developed and certified as actuarially sound, in accordance with 42 CFR §438.6. The certification shall identify historical utilization of state plan and HCBS services used in the rate development process.

Appears in 2 contracts

Samples: dhss.delaware.gov, www.medicaid.gov

Managed Care Requirements. The state State must comply with the managed care regulations published at 42 CFR 438. Capitation rates shall be developed and certified as actuarially sound, sound in accordance with 42 CFR 438.6. The certification shall identify historical utilization of state plan and HCBS State Plan services used in the rate development process.. The State must provide for the following:

Appears in 1 contract

Samples: www.medicaid.gov

Managed Care Requirements. The state must comply with the managed care regulations published at 42 CFR 438. Capitation rates shall be developed and certified as actuarially sound, sound in accordance with 42 CFR 438.6. The certification shall identify historical utilization of state plan and HCBS services used in the rate development process.process.‌ The state must maintain:

Appears in 1 contract

Samples: ahca.myflorida.com

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Managed Care Requirements. The state State must comply with the managed care regulations published at 42 CFR 438. Capitation rates rates, including both components of the comprehensive and catastrophic components, shall be developed and certified as actuarially sound, sound in accordance with 42 CFR 438.6. The certification shall identify historical utilization of state plan and HCBS State Plan services used in the rate development process.

Appears in 1 contract

Samples: ahca.myflorida.com

Managed Care Requirements. The state must comply with the managed care regulations published at 42 CFR 438. Capitation rates shall be developed and certified as actuarially sound, sound in accordance with 42 CFR 438.6. The certification shall identify historical utilization of state plan and HCBS services used in the rate development process.. The state must maintain:

Appears in 1 contract

Samples: static-lobbytools.s3.amazonaws.com

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