Medical Education and Research Trust Fund Sample Clauses

Medical Education and Research Trust Fund. Money (MERC). The STATE shall make payments to the MERC Trust Fund on behalf of the MCO as calculated by the STATE, or up to the aggregate dollar amount paid to the MERC Trust Fund for STATE fiscal year 2009 (the baseline year for MERC funds), consistent with Minnesota Statutes, § 256B.69, subd. 5c.
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Medical Education and Research Trust Fund. Money (MERC). (A) Appendix II-A and II-A1 includes for the Contract Year: (1) A set of capitation rates with MCO specific MERC and Disproportionate Hospital Utilization (DHU) funding in the rates. (2) A set of capitation rates with MCO specific MERC funding out of the rates. (3) A set of capitation rates with MCO specific MERC and DHU funding out of the rates. (4) The dollar difference between (1) and (2) above which is the amount of the rate attributable to medical education and being removed (“carved out”) from the rates prior to payment to the MCO. (5) The dollar difference between (2) and (3) above, which is the MCO’s specific DHU rate. (B) The STATE shall: (1) Reduce the payments to the MCO by the amount in section 4.1.6(A)(4) above; (2) The STATE shall make payments to the MERC Trust Fund on behalf of the MCO in the amount of the lesser of section 4.1.6(A)(4) or the aggregate dollar amount carved out of the Medical Assistance capitation rates and paid to the MERC Trust Fund for STATE fiscal year 2009 (the baseline year for MERC funds). (3) The State shall reflect on the remittance advice the total reimbursement amount to the MCO, and the amount of medical education dollars carved out.
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Medical Education and Research Trust Fund. Money (MERC). In Appendix II, Appendices 1A, 1B and 1C, include for calendar year 2010: (A) A set of capitation rates with MCO specific MERC and Disproportionate Hospital Utilization (DHU) (for non-Duals only) funding in the rates (column 7). (B) A set of capitation rates with MCO specific MERC funding out of the rates (column 6). (C) A set of capitation rates with MCO specific MERC and DHU (for non-Duals only) funding out of the rates (column 5). (D) The dollar difference between (column 7) and (column 6) which is the amount of the rate attributable to medical education and being removed (carved out) from the rates prior to payment to the MCO. (E) The MCO’s specific DHU rate is in column 2.
Sample 1
Medical Education and Research Trust Fund. Money (MERC). (A) Appendix II includes for the Contract Year, for MSC+ : (1) A set of capitation rates with MCO specific MERC funding included. Disproportionate Hospital Utilization (DHU) funding is not separately identified in the MSHO/MSC+ rates; (2) A set of capitation rates with MCO-specific MERC funding out of the rates; (3) The dollar difference between (1) and (2) above which is the amount of the rate attributable to medical education and being removed (“carved out”) from the rates prior to payment to the MCO. (B) The STATE shall: (1) Reduce the payments to the MERC Trust Fund on behalf of the MCO and reduce the payment to the MCO by the amount in section 4.2.9(A)(3). (2) The STATE shall make payments to the MERC Trust Fund on behalf of the MCO in the amount of the lesser of section 4.2.9(A)(3) or the aggregate dollar amount carved out of the Medical Assistance capitation rates and paid to the MERC Trust Fund in state fiscal year 2009 (the baseline year for MERC funds). (3) The STATE shall reflect on the remittance advice the total reimbursement amount to the MCO, and the amount of medical education dollars carved out. (4) Once the MERC limit described in 4.2.9(B)(2) is reached, the carve-out will continue, but the transfer of the MERC funds will stop.
Sample 1
Medical Education and Research Trust Fund. Money (MERC). (A) Appendix II A and II B include for the Contract Year, for MSC+ : (1) A set of capitation rates with MCO specific MERC and Disproportionate Hospital Utilization (DHU) funding in the rates; (2) A set of capitation rates with MCO specific MERC funding out of the rates; and‌ (3) The dollar difference between (1) and (2), which is the amount of the rate attributable to medical education and being removed (“carved out”) from the rates prior to payment to the MCO.‌ (B) The STATE shall: (1) Reduce the payments to the MERC Trust Fund on behalf of the MCO and reduce the payment to the MCO by the amount in section 4.5.5(A)(3). (2) The STATE shall make payments to the MERC Trust Fund on behalf of the MCO in the amount of the lesser of 4.5.5(A)(3) above or the aggregate dollar amount carved out of the Medical Assistance capitation rates and paid to the MERC Trust Fund in STATE fiscal year 2010. (3) The STATE shall reflect on the remittance advice the total reimbursement amount to the MCO, and the amount of medical education dollars carved out. (4) Once the MERC limit described in (2) is reached, the carve-out will continue, but the transfer of the MERC funds will stop.
Sample 1
Medical Education and Research Trust Fund. Money (MERC). (A) Appendix II A and II B include for the Contract Year, for MSC+ :
Sample 1
Medical Education and Research Trust Fund. Money (MERC). (A) Appendix II includes for the Contract Year, for MSC+ : (1) A set of capitation rates with MCO specific MERC and Disproportionate Hospital Utilization (DHU) funding in the rates; (2) A set of capitation rates with MCO-specific MERC funding out of the rates; and (3) The dollar difference between (1) and (2), which is the amount of the rate attributable to medical education and being removed (“carved out”) from the rates prior to payment to the MCO. (B) The STATE shall: (1) Reduce the payments to the MERC Trust Fund on behalf of the MCO and reduce the payment to the MCO by the amount in section 4.5.6(A)(3) above. (2) The STATE shall make payments to the MERC Trust Fund on behalf of the MCO in the amount of the lesser of section 4.5.6(A)(3) above or the aggregate dollar amount carved out of the Medical Assistance capitation rates and paid to the MERC Trust Fund in STATE fiscal year 2009 (the baseline year for MERC funds). (3) The STATE shall reflect on the remittance advice the total reimbursement amount to the MCO, and the amount of medical education dollars carved out.
Sample 1
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Medical Education and Research Trust Fund. Money (MERC). 39 Section 4.1.5. Risk Adjusted Payments. 39
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