Third Party Liability and Recovery. Medicaid HMOs are responsible for establishing a plan and process for recovering costs for services that should have been paid through a third party in accordance with State and Federal law and regulations. To recognize this requirement, capitation payments to the HMOs are reduced by the projected amount of TPR that the HMO is expected to recover.
Appears in 16 contracts
Samples: Contract Amendment (Centene Corp), Contract Amendment (Centene Corp), Contract Amendment (Centene Corp)