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.

  • In return for Capitation Payments, the Contractor agrees to provide eligible members with the medical care and services described in this ARTICLE II: HEALTH PLAN PROGRAM STANDARDS and subsequent Attachments hereto, subject to any stop-loss provisions.

  • 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.

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

  • 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.

  • 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.

  • For each applicable HMO Program, HHSC will pay the HMO fixed monthly Capitation Payments based on the number of eligible and enrolled Members.

  • In consideration of the Monthly Capitation Payment(s), the HMO agrees to provide the Services and Deliverables described in this Contract.


More Definitions of Capitation Payments

Capitation Payments means two or more Capitation Payments.
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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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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.

  • Production Payments means, collectively, Dollar-Denominated Production Payments and Volumetric Production Payments.

  • 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.

  • Passthru payments means any withholdable payment and any "foreign passthru payment," which is currently not defined. The current proposed FATCA regulations (“Proposed Regulations”) state that the Internal Revenue Service and the U.S. Treasury have determined, that withholding on “foreign passthru payments” is not required, pending further guidance and analysis. The Proposed Regulations provide that such withholding will not be effective before the date that is two years after the publication of final regulations defining the term “foreign pass-thru payment”.

  • Termination Payments has the meaning specified in Section 10(a).