PAYMENTS TO COUNTY. A. CAPITATION RATES In consideration of full compliance by the County with contract requirements, the Department agrees to pay the County monthly payments based on the capitation rate specified and subject to the conditions of this Contract. The capitation rate shall not include any amount for recoupment of losses incurred by the County under previous Contracts nor does it include services that are not covered under the State Plan.
B. ACTUARIAL BASIS OF CAPITATION RATE The capitation rate is calculated on an actuarial basis recognizing the payment limits set forth in federal law 42 CFR 438.6(c).
C. RENEGOTIATION The monthly capitation rates set forth in this article are recalculated on an annual basis. The County will have 30 calendar days from the date of the written notification to accept the new capitation rates in writing or to initiate termination or non-renewal of the Contract. The capitation rates are not subject to renegotiation once they have been accepted, unless such renegotiation is required by changes in federal or state laws, rules or regulations.
X. XXXXXXXXXXX The County may obtain a risk-sharing arrangement from an insurer other than the Department for coverage of enrollees under this Contract, provided that the County remains substantially at risk for providing services under this Contract.
E. RESPONSIBILITY TO PROVIDE SERVICES The County is responsible for the provision of Contract and administrative services covered under this Contract from the date the recipient is enrolled in the County, regardless of whether or not the County receives a capitation payment for that recipient for the initial month pursuant to the conditions agreed upon.
F. PAYMENT SCHEDULE Capitation payments to the County shall be based on County Enrollment Reports, which the Department will transmit to the County. Payment for each person listed as an ADD or CONTINUE on County Enrollment Reports shall be made within 134 days of the date the report is generated.
G. COORDINATION OF BENEFITS (COB) The County must actively pursue, collect and retain all monies from all available resources for services to enrollees covered under this Contract except where the amount of reimbursement the County can reasonably expect to receive is less than the estimated cost of recovery. COB recoveries will be done by post-payment billing (pay and chase) for certain preventive pediatric services. Post-payment billing will also be done in situations where the third party liability is derived...
PAYMENTS TO COUNTY. 7.1.1 In consideration of the granting of this franchise, and for the privilege of providing solid waste service along and within the rights-of-way of the county, Franchisee shall pay to County a franchise fee equal to ten percent (10%) of Franchisee's annual gross receipts attributable to services provided under this Agreement.
7.1.2 Franchisee shall submit to Director an annual detailed revenue statement and Franchisee shall pay its franchise fee to County, submitted to Director on a monthly basis. Payment of the monthly portion of the franchise fee shall be rendered to County monthly on or before the last business day of the following month in which Franchisee derives receipts for the services provided under the terms of this Agreement..
7.1.3 In the event that payment is not received by County within thirty (30) days after the date specified in this Section, then Franchisee shall pay a penalty of ten percent (10%) on the outstanding balance, and Franchisee shall also pay to County interest on the outstanding balance at a rate of ten percent (10%) per annum, or the maximum legal rate of interest, whichever is greater, from the date of Franchisee's failure to pay.
7.1.4 The parties agree that such late charges represent a fair estimate of County’s added administrative expenses caused by such delinquent payments.
7.1.5 In the event of an underpayment of franchise fees by Franchisee, within thirty
PAYMENTS TO COUNTY. CONTRACTOR shall reimburse COUNTY for the costs of program certification, administration and ongoing monitoring activities. CONTRACTOR will remit verification of said costs to COUNTY Auditor-Controller, no later than thirty (30) days following the close of each calendar quarter:
PAYMENTS TO COUNTY. 1.1 Amounts due to County under this Contract will be determined as follows:
PAYMENTS TO COUNTY. A. CAPITATION RATES In consideration of full compliance by the County with contract requirements, the Department agrees to pay the County monthly payments based on the capitation rate specified and subject to the conditions of this Contract. Capitation payments will only be made for Medicaid-eligible enrollees. The capitation rates shall be prospective and based on an actuarially sound methodology as required by federal regulations. The capitation rate shall not include any amount for recoupment of losses incurred by the County under previous Contracts nor does it include services that are not covered under the State Plan. No payment shall be made to a network provider other than by the County for services covered under this contract, except when these payments are specifically required by the State in Title XIX of the Act, in 42 CFR chapter IV, or when the State makes direct payments to network providers for graduate medical education costs approved under the State plan.
B. ACTUARIAL BASIS OF CAPITATION RATE The capitation rate is calculated on an actuarial basis recognizing the payment limits set forth in federal law 42 CFR §438.6(c).
PAYMENTS TO COUNTY. 2.1 Amounts due to County under this agreement will be determined as follows:
a) Fees and sales. Amounts collected by Contractor for sales and fees itemized in the following schedule are the property of the County: ▪ Drop-in camping fees ▪ Extra vehicle fees ▪ Firewood sales ▪ Parking fees ▪ Annual parking pass sales
2.2 Deposits of money due to County:
a) Fees and sales. All amounts collected by Contractor for fees and sales must be reported and deposited to the County weekly. Contractor must submit a completed Caretaker’s Weekly Income and Deposit Report to County at the same time the deposit is made.
PAYMENTS TO COUNTY. FRANCHISEE does not timely and fully make any payment to COUNTY required under this AGREEMENT (including payment of Franchise Fees):
a. More than twice in any calendar year;
b. Within 30 days of Notice by COUNTY that payment is due; or
c. With respect to payment of a shortfall in Franchise Fees, within 30 days of Notice in accordance with Section 11C.
PAYMENTS TO COUNTY. Subject to Section 5 and provided this Agreement has not been terminated in accordance with Section 4, commencing on the Effective Date and continuing until the first to occur of (a) the twenty-fifth (25th) anniversary of the date of approval of the Plan, (b) payment to the County of a total of Six Million One Hundred Fifty Thousand Dollars or (c) a Termination Event described in Section 4 (the Term), the City shall pay to the County on or before the day of each month, all of the County TIF Revenues in the County Account. In no event shall the total of payments of County Revenues to the County exceed $6,150,000.00.
PAYMENTS TO COUNTY. Palcare will provide the Commission and the County within 30 days of the end of each quarter ending on September 30, December 31, March 31 and June 30, documentation of the actual costs billed each month in each quarter in accordance with this Agreement. Each quarter, the Commission will pay the County the amounts required under the City Agreement, and the County shall pay such amounts to Palcare under this Agreement, based upon quarterly invoices submitted by Palcare to the County not to exceed the maximum Quarterly Payment Amounts set forth in Section 2.A. The quarterly invoices shall clearly show the total amount due, as well as a detailed breakdown of how such amount was determined. Specifically, the invoices shall include the following schedules for each month in the quarter under consideration: Schedule Required Information
1. Flexible Scheduling Fee for families that do not qualify for DOE or the Airport Scholarship Program Subsidy.
PAYMENTS TO COUNTY. During fiscal year 2008-09, the County will require Palcare to provide the Commission and County within 30 days of the end of each quarter ending on September 30, December 31, March 31 and June 30, documentation of the actual costs billed in accordance with this Agreement. The Commission will pay the County the quarterly amounts required under this Agreement based upon quarterly invoices submitted by Palcare to the County not to exceed $90,000 quarterly, or $306,500 annually, each such amount to be increased each fiscal year starting with fiscal year 2009-10 as provided in Section 2.A. The quarterly invoices shall clearly show the total amount due, as well as a detailed breakdown of how such amount was determined. Specifically, the invoices shall include the following schedules for each month in the quarter under consideration: Schedule Required Information
1. Flexible Scheduling Fee for families that do not qualify for the Airport Scholarship Program Subsidy. 2a. Airport Scholarship Subsidy for qualifying families that also receive DOE subsidies. 2b. Airport Scholarship Subsidy for qualifying families that do not receive DOE subsidies.
