Common use of Risk Adjustment Clause in Contracts

Risk Adjustment. The MCO SNP will notify the STATE or its actuarial firm of its restated mid-year HCC risk adjustment score and additional HCC Frailty factor score for MSHO. Scores will be from restated data based upon the preceding calendar year as reported by CMS. The MCO SNP will send this information to the STATE, or its actuaries, within thirty (30) days of CMS making it available to the MCO. The actuarial firm may share information about the risk score with the STATE, but the STATE will not receive copies of this information. The MCO must identify this information as trade secret prior to, or at the time of its submission for the STATE to consider classifying it as non-public, as described in section 9.6. HOS Health Outcomes Survey. By October 15th of each Contract Year, or within thirty (30) days of availability, the MCO will provide the STATE the current HOS report for MSHO submitted to CMS. Quality Assurance Materials. Information as specified in Article 7 on Quality Assessment and Performance Improvement.

Risk Adjustment. The MCO SNP will notify the STATE or its actuarial firm of its restated mid-year HCC risk adjustment score and additional HCC Frailty factor score for MSHOscore. Scores will be from restated data based upon the preceding calendar year as reported by CMS. The MCO SNP will send this information to the STATE, or its actuaries, within thirty (30) days of CMS making it available to the MCO. The actuarial firm may share information about the risk score with the STATE, but the STATE will not receive copies of this information. The MCO must identify this information as trade secret prior to, or at the time of its submission for the STATE to consider classifying it as non-public, as described in section 9.6. HOS Health Outcomes Survey. By October 15th of each Contract Year, or The SNBC SNP will share Health Outcomes Survey (HOS) survey results with the State within thirty (30) days of availability, receiving the MCO will provide the STATE the current HOS report for MSHO submitted to CMSresults. Quality Assurance Materials. Information as specified in Article 7 on Quality Assessment and Performance Improvement.