Capitation Payment Mechanism definition

Capitation Payment Mechanism means a payment mechanism available for selection by the ACO for each Performance Year of the Agreement Performance Period as described in Section 8.01, under which CMS will make periodic payments to the ACO during the Performance Year. The Capitation Payment Mechanisms available for selection include PCC Payment and TCC Payment.
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Examples of Capitation Payment Mechanism in a sentence

  • If the ACO wishes to participate in TCC Payment for a Performance Year, it must select TCC Payment as the ACO’s Capitation Payment Mechanism as described in Section 8.01.

  • If the ACO selects PCC Payment as its Capitation Payment Mechanism, the ACO must select the maximum Enhanced PCC Percentage as described in Section 8.01 from within the range specified in Appendix E, and may select to participate in the APO as described in Section 8.01.

  • If the ACO wishes to participate in PCC Payment for a Performance Year, it must select PCC Payment as the ACO’s Capitation Payment Mechanism as described in Section 8.01.

  • If the ACO has selected the Professional Risk Sharing Option, the ACO may only select PCC Payment as its Capitation Payment Mechanism.

  • If the ACO has selected the Global Risk Sharing Option, the ACO may select TCC Payment or PCC Payment as its Capitation Payment Mechanism.

  • For purposes of furnishing Benefit Enhancements and participating in the ACO’s selected Capitation Payment Mechanism, the removal of an individual or entity from the Participant Provider List or Preferred Provider List will be effective on the last day of the month the individual or entity ceases to meet the requirements of Section 4.01.A(1)-(5) or Section 4.01.B(1)-(5), as applicable.

  • The ACO may select only one Capitation Payment Mechanism for a Performance Year.

  • If the ACO has selected TCC Payment as its Capitation Payment Mechanism, the arrangement prohibits a Participant Provider that is added to the Participant Provider List during a Performance Year or a Preferred Provider that is added to the Preferred Provider List during a Performance Year from participating in the ACO’s selected Capitation Payment Mechanism for the Performance Year in which the Participant Provider or Preferred Provider is so added.

  • If the ACO has selected PCC Payment as its Capitation Payment Mechanism, the arrangement prohibits a Participant Provider that is added to the Participant Provider List during a Performance Year or a Preferred Provider that is added to the Preferred Provider List during a Performance Year from participating in the ACO’s selected Capitation Payment Mechanism for the Performance Year in which the Participant Provider or Preferred Provider is so added.

  • For each Performance Year, CMS shall pay the ACO in accordance with (1) the Capitation Payment Mechanism selected by the ACO as described in Section 8.01 and, if selected by the ACO as described in Section 8.01, the APO; (2) the Risk Sharing Option (Global or Professional) that the ACO selected as described in Article VIII; (3) Appendix B; (4) Article XI; and (5) this Article XII.

Related to Capitation Payment Mechanism

  • Alternative Payment Mechanism means, with respect to any securities or combination of securities (together in this definition, “such securities”), provisions in the related transaction documents requiring the Corporation to issue (or use commercially reasonable efforts to issue) one or more types of APM Qualifying Securities raising eligible proceeds at least equal to the deferred Distributions on such securities and apply the proceeds to pay unpaid Distributions on such securities, commencing on the earlier of (x) the first Distribution Date after commencement of a deferral period on which the Corporation pays current Distributions on such securities and (y) the fifth anniversary of the commencement of such deferral period, and that

  • Capitation Payment means a payment the STATE makes periodically to the MCO for each Enrollee covered under the Contract for the provision of services as defined in Article 6 regardless of whether the Enrollee receives these services during the period covered by the payment.

  • Structured settlement annuity means an annuity purchased in order to fund periodic payments for a plaintiff or other claimant in payment for or with respect to personal injury suffered by the plaintiff or other claimant.

  • Payment Method means a payment method that Stripe accepts as part of the Stripe Payments Services (e.g., a Visa credit card, Klarna).

  • Structured settlement payment rights means rights to receive periodic payments under a structured settlement, whether from the structured settlement obligor or the annuity issuer, where:

  • Individual Settlement Payment means the amount payable from the Net

  • Gross Settlement Amount means $240,000 which is the total amount Standard agrees to pay under the Settlement, except as provided in Paragraph 8 below. The Gross Settlement Amount will be used to pay Individual Class Payments, Individual PAGA Payments, the LWDA PAGA Payment, Class Counsel Fees, Class Counsel Expenses, Class Representative Service Payment and the Administrator’s Expenses.

  • Debit Payment means a particular transaction where a debit is made.

  • Settlement Method means, with respect to any conversion of Notes, Physical Settlement, Cash Settlement or Combination Settlement, as elected (or deemed to have been elected) by the Company.

  • Amortization Payment shall have the meaning set forth in Section 2(d).

  • Event Payments has the meaning set forth in Section 6.1(d).

  • Net Settlement Amount means the Gross Settlement Amount, less the following payments in the amounts approved by the Court: Individual PAGA Payments, the LWDA PAGA Payment, Class Representative Service Payment, Class Counsel Fees Payment, Class Counsel Litigation Expenses Payment, and the Administration Expenses Payment. The remainder is to be paid to Participating Class Members as Individual Class Payments.

  • Net Benefits Test means a calculation to determine whether the benefits of a reduction in price resulting from the dispatch of Economic Load Response exceeds the cost to other loads resulting from the billing unit effects of the load reduction, as specified in Operating Agreement, Schedule 1, section 3.3A.4 and the parallel provisions of Tariff, Attachment K-Appendix, section 3.3A.4.

  • Physical Settlement Amount For any Settlement Date for which Physical Settlement is applicable, an amount in cash equal to the product of (a) the Forward Price in effect on the relevant Settlement Date multiplied by (b) the Settlement Shares for such Settlement Date.

  • AHYDO Catch-Up Payment means any payment with respect to any obligations of the Borrower or any Restricted Subsidiary, in each case to avoid the application of Section 163(e)(5) of the Code thereto.

  • Viatical settlement provider means a person, other than a viator, who enters into or effectuates a viatical settlement contract. Viatical settlement provider does not include:

  • prepayment meter means a meter that can be programmed to allow the flow of pre-purchased amounts of energy in an electrical circuit;

  • Net Share Settlement Amount For any Settlement Date, an amount equal to the product of (i) the number of Warrants exercised or deemed exercised on the relevant Exercise Date, (ii) the Strike Price Differential for the relevant Valuation Date and (iii) the Warrant Entitlement.

  • Separation Payment means any lump sum cash payment in excess of Earned Salary and Accrued Obligations payable to Employee under this Agreement.

  • Capitation rate means the fee the department pays monthly to an HMO for each enrolled recipient for the provision of covered medical and health services whether or not the enrolled recipient received services during the month for which the fee is intended.

  • Payment month means, for all programs except EA, the calendar month for which benefits are issued.

  • Payment Amount as defined in Section 3.5.

  • Credit Support Amount has the meaning specified in Paragraph 3.

  • Settlement Amount has the meaning specified in Section 14.02(a)(iv).

  • Capitation means the reimbursement arrangement in which a fixed rate of payment per Enrollee per month is made to the Contractor for the performance of all of the Contractor’s duties and obligations pursuant to this Contract.

  • Distribution Payment Date has the meaning set forth in paragraph 2(b) of Annex I.