Performance Year Expenditures. For purposes of conducting financial settlement pursuant to Section VIII.C of the Agreement, expenditures will be calculated separately for each of the two Entitlement Categories: ESRD Beneficiaries and A/D Beneficiaries. CMS will apply the same inclusions and exclusions in determining the Performance Year expenditures as those described in Section III.C of this Appendix with respect to determining the Base Year expenditures for purposes of the calculation of the Performance Year Benchmark, except that only Medicare claims with a date of service during the Performance Year and that are paid within 3 months of the close of the Performance Year will be included. The total Performance Year expenditure is the sum of the following two amounts:
Performance Year Expenditures. For purposes of conducting financial settlement pursuant to Section XIII.C of the Agreement, expenditures will be calculated separately for each of the two Entitlement Categories: ESRD Beneficiaries and A/D Beneficiaries. CMS will apply inclusions and exclusions in determining the Performance Year expenditures as described in Section IV.C.1 of this Appendix for Medicare claims with a date of service during the Performance Year and that are paid within 6 months of the close of the Performance Year. CMS may, at CMS’s sole discretion, modify the inclusions and exclusions used in determining the Performance Year expenditures as needed for consistency with the GMCB’s Performance Year Benchmark methodology for purposes of conducting financial settlement. The total Performance Year expenditure is the sum of the following two amounts:
Performance Year Expenditures. For purposes of conducting financial settlement pursuant to Section XIII.C of the Agreement, expenditures will be calculated separately for each of the two Entitlement Categories: ESRD
