Uncapped expenditures Clause Samples

Uncapped expenditures. ‌ If applicable, the uncapped expenditures for a base-year or Performance Year that accrues to the entitlement category by the beneficiary is the total Medicare Part A and Part B expenditures accrued to the entitlement category by the beneficiary during such base–year or Performance Year, as applicable. These uncapped expenditures will be used to calculate both the baseline expenditures and the Performance Year expenditures in a Performance Year in which the ACO’s expenditure cap selection is uncapped expenditures. All other calculations that require use of expenditures will be on a capped basis using the methods described in 3.8.1 (e.g., efficiency ratio calculation).