Capitation Payments definition

Capitation Payments. A payment the Division makes periodically to the Contractor on behalf of each Member enrolled under this Contract and based on the actuarially sound capitation rate developed as defined in 42 C.F.R. §438.4 for the provision of services under the State plan. The Division makes the payment regardless of whether the particular Member receives services during the period covered by the payment.
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Capitation Payments means the financial resources transferred by the Recipient to Selected Municipalities calculated as an annual average per capita amount initially determined to be the equivalent in Córdobas to USD3.6 needed to ensure the access of Eligible Beneficiaries (as hereinafter defined) to the Health Services.
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Capitation Payments means the payments described in Attachment 1.1 to be made ------------------- -------------- by the Plan to PHE for Covered Services.
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Examples of Capitation Payments in a sentence

  • HHSC will calculate the monthly Capitation Payments by multiplying the number of Members by each applicable Member Rate Cell.

  • The Member Listing Report shall serve as the basis for Capitation Payments to the Contractor for the ensuing month.

  • The prohibition on advances to Subcontractors contained in this subsection shall not apply to Capitation Payments or payments made by the Contractor to Contractor’s Network for provision of Covered Services.

  • The time period of retroactive eligibility may exceed 12 months; however, the Department shall pay up to 12 months of Capitation Payments to the Contractor and the Contractor shall be responsible for providing Covered Services during those 12 months.

  • To facilitate this payment, the Contractor shall provide the Department with the Insurer’s Premium Fee assessment received from the Federal Government and the pro rata portion attributed to the Contractor’s Capitation Payments under its Contract(s) for the preceding calendar year if available.

  • HHSC will calculate the monthly Capitation Payments by multiplying the number of Member months times the applicable monthly Capitation Rate by Member rate cell.

  • As noted in Section 6.2, HHSC will pay the HMO monthly Capitation Payments based on the number of eligible and enrolled Members.

  • The HMO must provide the Services and Deliverables, including Covered Services to enrolled Members in order for monthly Capitation Payments to be paid by HHSC.

  • If the Contractor is or will be subject to the health insurer’s premium fee for the Capitation Payments being made under this or a previously existing Managed Care Contract with the Commonwealth, the Commonwealth shall compensate the Contractor for that fee and for any federal taxes resulting from such compensation.

  • In calculating Capitation Payments due to Medical Group, PacifiCare shall deduct the ISL Premium amount set forth herein from the amounts otherwise due to Medical Group, unless PacifiCare has approved of Medical Group’s opting out of PacifiCare’s ISL Program.


More Definitions of Capitation Payments

Capitation Payments means the predetermined monthly fee paid by RHS to Provider in consideration of the Agreement of Primary Care Provider to provide Covered Services to Members who have been assigned to Provider. To the extent a fee of this nature is paid to Primary Care Provider under this Agreement, such fee is calculated on the basis of the formula(s) set forth in the Payment Appendix.
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Capitation Payments means two or more Capitation Payments.
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Related to Capitation Payments

  • 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.

  • Compensation Payment means a payment, whether in monetary form or in the form of a benefit or service, by or on behalf of an insurer to a complainant to compensate the complainant for a proven or estimated financial loss incurred as a result of the insurer’s contravention, non-compliance, action, failure to act, or unfair treatment forming the basis of the complaint, where the insurer accepts liability for having caused the loss concerned, but excludes any –

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

  • Rental Payments means the rental payments paid by the occupant of a unit, excluding any supplemental rental assistance to the occupant from the State, the federal government, or any other public agency, but including any mandatory fees or charges imposed on the occupant by the Owner as a condition of occupancy of the unit.

  • FILOT Payments means the amount paid or to be paid in lieu of ad valorem property taxes as provided herein.