Uniform Managed Care Contract Terms & Conditions Version 2.1Centene Corp • April 24th, 2012 • Hospital & medical service plans • Texas
STAR, CHIP, CHIP Perinatal, and STAR+PLUS Program results will be consolidated. For a given MCO, total incurred administrative expenses, as reported on the FSRs for the MCO’s Service Areas and/or Programs, will be summed, and compared to the total Admin Caps for the MCO’s various Service Areas and Programs. Thus, an MCO that exceeds its Admin Cap limit in one (1) or more Service Areas or Programs, but does not exceed the Admin Cap in another Service area or Program, may have an offset. The net impact of the Admin Cap across relevant FSRs will be applied to the Experience Rebate calculation.
