Common use of RATE DEVELOPMENT STANDARDS Clause in Contracts

RATE DEVELOPMENT STANDARDS. i. Overview The MyCare rates have been developed as full risk rates. The MCOPs assume risk for the cost of services covered under the contract and incur losses if the cost of furnishing the services exceeds the payments under the contract. The regional NFLOC rates will be prospectively adjusted by MCOP to reflect mix differences in the enrolling population between nursing facility and Community Waiver setting of care. This adjustment will be made to the rates prospectively. No additional risk adjustment is planned for this population in CY 2022.

RATE DEVELOPMENT STANDARDS. i. Overview The MyCare rates have been developed as full risk rates. The MCOPs assume risk for the cost of services covered under the contract and incur losses if the cost of furnishing the services exceeds the payments under the contract. The regional NFLOC rates will be prospectively adjusted by MCOP to reflect mix differences in the enrolling population between nursing facility and Community Waiver setting of care. This adjustment will be made to the rates prospectively. No additional risk adjustment is planned for this population in CY 20222018.

RATE DEVELOPMENT STANDARDS. i. Overview The MyCare rates have been developed as full risk rates. The MCOPs assume risk for the cost of services covered under the contract and incur losses if the cost of furnishing the services exceeds the payments under the contract. The regional NFLOC rates will be prospectively adjusted by MCOP to reflect mix differences in the enrolling population between nursing facility and Community Waiver setting of care. This adjustment will be made to the rates prospectively. No additional risk adjustment is planned for this population in CY 20222021.