Common use of Reasonableness of withhold arrangement Clause in Contracts

Reasonableness of withhold arrangement. Our review of the total withhold percentage of 3% of capitation revenue indicates that it is reasonable within the context of the capitation rate development and the magnitude of the withhold does not have a detrimental impact on the MCOP’s financial operating needs and capital reserves. Our interpretation of financial operating needs relates to cash flow needs for the MCOP to pay claims and administer benefits for its covered population. We evaluated the reasonableness of the withhold within this context by reviewing the MCOP’s cash available to cover operating expenses, as well as the capitation rate payment mechanism utilized by ODM.

Reasonableness of withhold arrangement. Our review of the total withhold percentage of 3% of capitation revenue indicates that it a full return of the withhold is reasonable within the context of the capitation rate development and the magnitude of the withhold does not have a detrimental impact on the MCOP’s financial operating needs and capital reserves. Our interpretation of financial operating needs relates to cash flow needs for the MCOP to pay claims and administer benefits for its covered population. We evaluated the reasonableness of the withhold within this context by reviewing the MCOP’s cash available to cover operating expenses, as well as the capitation rate payment mechanism utilized by ODM.

Reasonableness of withhold arrangement. Our review of the total withhold percentage of 33.0% of capitation revenue indicates that it is reasonable within the context of the capitation rate development and the magnitude of the withhold does not have a detrimental impact on the MCOPMCP’s financial operating needs and capital reserves. Our interpretation of financial operating needs relates to cash flow needs for the MCOP MCP to pay claims and administer benefits for its covered population. We evaluated the reasonableness of the withhold within this context by reviewing the MCOPMCP’s cash available to cover operating expenses, as well as the capitation rate payment mechanism utilized by ODM.