Prospective Program Adjustments Sample Clauses

Prospective Program Adjustments. The SFY 2008/2009 Budget contains several program changes that impacted the development of the capitation rates. The program changes include items such as provider fee changes, benefit changes, and administrative changes. Adjustments to the CY 2006 experience were developed for each item based on its expected impact to the prospective claims cost. Table 8 lists the program changes that were included in the CY 2008 capitation rate development. Nursing Facility Fee Increase 7/1/2007 7/1/2008 Nursing Facility All Rate Groups (excl. Delivery) Chiropractor Benefit Restoration 1/1/2008 Miscellaneous Services HF M – 19 to 44 HF F – 19 to 44 HF M/F – 45 to 64 HST F – 19 to 64 Independent Psychologists Benefit Restoration 1/1/2008 Mental Health / Substance Abuse HF M – 19 to 44 HF F – 19 to 44 HF M/F – 45 to 64 HST F – 19 to 64 Occupational Therapy-Independent Provider Status 1/1/2008 Miscellaneous Services All Rate Groups (excl. Delivery) Developmental Therapies 1/1/2008 Miscellaneous Services HST M/F - < 1 Xxxxxx Children Expansion 1/1/2008 All Service Categories HST M – 14 to 18 CHIP III Expansion 1/1/2008 All Service Categories HST F – 14 to 18 HF M – 19 to 44 HF F – 19 to 44 HST F – 19 to 64 HST M/F – 2 to 13 Pregnant Women Expansion 1/1/2008 All Service Categories HST M – 14 to 18 HST F – 14 to 18 HST F – 19 to 64 Improved TPL Management 1/1/2008 All Service Categories Delivery All Rate Groups (incl. Delivery) Expedite Managed Care Enrollment 1/1/2008 All Service Categories All Rate Groups (incl. Delivery) Expedite Newborn Enrollment 1/1/2008 All Service Categories HST M/F - < 1 Short Term Nursing Facility Policy Change (consistent with ABD) 1/1/2008 Nursing Facility All Rate Groups (excl. Delivery) Prior Authorization Policy Change 1/1/2008 Pharmacy All Rate Groups (excl. Delivery) Prior Authorization of Atypical Anti-Psychotic Medication 1/1/2008 Pharmacy All Rate Group (excl. Delivery)
Sample 1
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Prospective Program Adjustments. The SFY 2008/2009 Budget contains several program changes that impacted the development of the capitation rates. The program changes include items such as provider fee changes, benefit changes, and administrative changes. Adjustments to the CY 2006 experience were developed for each item based on its expected impact to the prospective claims cost. Table 5 lists the program changes that were included in the CY 2008 capitation rate development. Milliman makes no representations or warranties regarding the contents of this letter to third parties. Likewise, third parties are instructed that they are to place no reliance upon this letter prepared for ODJFS by Milliman that would result in the creation of any duty or liability under any theory of law by Milliman or its employees to third parties. Other parties receiving this letter must rely upon their own experts in drawing conclusions about the information presented. Nursing Facility Fee Increase 7/1/2007 Nursing Facility Chiropractor Benefit Restoration 1/1/2008 Miscellaneous Services Independent Psychologists Benefit Restoration 1/1/2008 Mental Health / Substance Abuse Occupational Therapy-Independent Provider Status 1/1/2008 Miscellaneous Services Improved TPL Management 1/1/2008 All Service Categories Prior Authorization Policy Change 1/1/2008 Pharmacy Prior Authorization of Atypical Anti-Psychotic Medication 1/1/2008 Pharmacy
Sample 1

Related to Prospective Program Adjustments

  • Performance Adjustment One-twelfth of the annual Performance Adjustment Rate will be applied to the average of the net assets of the Portfolio (computed in the manner set forth in the Fund's Declaration of Trust or other organizational document) determined as of the close of business on each business day throughout the month and the performance period.

  • Program Changes Contractor agrees to inform the County of any alteration in program or service delivery at least thirty (30) days prior to the implementation of the change, or as soon as reasonably feasible.

  • Stock Adjustments In the event that during the term of the pledge any stock dividend, reclassification, readjustment or other changes are declared or made in the capital structure of Pledgee, all new, substituted and additional shares or other securities issued by reason of any such change shall be delivered to and held by the Pledgee under the terms of this Security Agreement in the same manner as the Shares originally pledged hereunder. In the event of substitution of such securities, Pledgor, Pledgee and Pledgeholder shall cooperate and execute such documents as are reasonable so as to provide for the substitution of such Collateral and, upon such substitution, references to "Shares" in this Security Agreement shall include the substituted shares of capital stock of Pledgor as a result thereof.

  • True-Up Adjustments From time to time, until the Retirement of the Recovery Bonds, the Servicer shall identify the need for True-Up Adjustments and shall take all reasonable action to obtain and implement such True-Up Adjustments, all in accordance with the following:

  • Adjustments to Prevent Dilution In the event that the Company changes the number of Shares or securities convertible or exchangeable into or exercisable for Shares issued and outstanding prior to the Effective Time as a result of a reclassification, stock split (including a reverse stock split), stock dividend or distribution, recapitalization, merger, issuer tender or exchange offer, or other similar transaction, the Per Share Merger Consideration shall be equitably adjusted.

  • Fee Adjustments The fixed fees and other fees expressed as stated dollar amounts in this Schedule C and in this Agreement are subject to annual increases, commencing on the one-year anniversary date of the date of this Agreement, in an amount equal to the percentage increase in consumer prices for services as measured by the United States Consumer Price Index entitled “All Services Less Rent of Shelter,” or a similar index should such index no longer be published, since such one-year anniversary or since the date of the last fee increase, as applicable.

  • Share Adjustments If the Company's outstanding shares of Common Stock are increased or decreased or changed into or exchanged for a different number or kind of shares or other securities of the Company by reason of any recapitalization, reclassification, stock split, combination of shares, stock dividend, or transaction having similar effect, the Board shall proportionately and appropriately adjust the number and kind of shares that are subject to this Option and the Exercise Price Per Share, without any change in the aggregate price to be paid therefor upon exercise of this Option.

  • Performance Evaluations The Contractor is subject to an annual performance evaluation to be conducted by NYCDOT pursuant to the PPB Rules.

  • Product Changes Vocera shall have the right, in its absolute discretion, without liability to End User, to update to provide new functionality or otherwise change the design of any Product or to discontinue the manufacture or sale of any Product. Vocera shall notify End User at least 90 days prior to the delivery of any Product which incorporates a change that adversely affects form, fit or function (“Material Change”). Vocera shall also notify End User at least 90 days prior to the discontinuance of manufacture of any Product. Notification will be made as soon as reasonably practical for changes associated with regulatory or health and safety issues.

  • Cost Adjustments Both parties agree that contracted prices shall be fixed for the first 12 months of this Contract. Contractor must submit to District any proposed cost adjustments at least 60 days before the proposed effective date of such increases with a detailed explanation for each adjustment. District alone reserves the right to reject any changes to this Contract it deems unacceptable.

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