Mandatory Sanction. Failure of the contractor to achieve the minimum screening rate shall require the following refund of capitation paid: i. Achievement of a 50 percent to less than 60 percent EPSDT screening, dental visit and immunization rate (the lowest measured rate of each of the components of EPSDT screening, i.e., periodic exam, immunization rate, and dental screening rate, shall be considered to be the rate for EPSDT participation and the basis for the sanction): refund of $1 per enrollee for all enrollees under age 21 not screened. ii. Achievement of a 40 percent to less than 50 percent EPSDT screening, dental visit, and immunization rate: refund of $2 per enrollee for all enrollees under age 21 not screened. iii. Achievement of a 30 percent to less than 40 percent EPSDT screening, dental visit and immunization rate: refund of $3 per enrollee for all enrollees under age 21 not screened. iv. Achievement of less than 30 percent: refund of $4 per enrollee for all enrollees under age 21 not screened.
Appears in 2 contracts
Samples: Contract to Provide Services (Centene Corp), Contract to Provide Services (Americhoice Corp)
Mandatory Sanction. Failure of the contractor to achieve the minimum screening rate shall require the following refund of capitation paid:
i. Achievement of a 50 percent to less than 60 percent EPSDT screening, dental visit and immunization rate (the lowest measured rate of each of the components of EPSDT screening, i.e., periodic exam, immunization rate, and dental screening rate, shall be considered to be the rate for EPSDT participation and the basis for the sanction): refund of $1 per enrollee for all enrollees under age 21 not screened.
ii. Achievement of a 40 percent to less than 50 percent EPSDT screening, dental visit, and immunization rate: ; refund of $2 per enrollee for all enrollees under age 21 not screened.
iii. Achievement of a 30 percent to less than 40 percent EPSDT screening, dental visit and immunization rate: refund of $3 per enrollee for all enrollees under age 21 not screened.,
iv. Achievement of less than 30 percent: refund of $4 per enrollee for all enrollees under age 21 not screened.
Appears in 1 contract
Samples: Agreement to Provide Hmo Services (Amerigroup Corp)
Mandatory Sanction. Failure of the contractor to achieve the minimum screening rate shall require the following refund of capitation paid:
i. Achievement of a 50 percent to less than 60 percent EPSDT screening, dental visit and immunization rate (the lowest measured rate of each of the components of EPSDT screening, i.e., periodic exam, immunization rate, and dental screening rate, shall be considered to be the rate for EPSDT participation and the basis for the sanction): refund of $1 per enrollee for all enrollees under age 21 not screened.
ii. Achievement of a 40 percent to less than 50 percent EPSDT screening, dental visit, visit and immunization rate: refund of $2 per enrollee for all enrollees under age 21 not screened.
iii. Achievement of a 30 percent to less than 40 percent EPSDT screening, dental visit and immunization rate: refund of $3 per enrollee for all enrollees under age 21 not screened.
iv. Achievement of less than 30 percent: refund of $4 per enrollee for all enrollees under age 21 not screened.
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