Experience Rebate definition

Experience Rebate means the portion of the HMO’s net income before taxes that is returned to the State in accordance with Section 10.11 for the STAR, CHIP and CHIP Perinatal Programs and 10.11.1 for the STAR+PLUS Program (“Experience Rebate”).

Experience Rebate means the portion of the MCO’s Net Income Before Taxes that is returned to the State in accordance with Section 10.10 for the STAR, CHIP and CHIP Perinatal Programs and 10.10.1 for the STAR+PLUS Program (“Experience Rebate”).

Experience Rebate means the portion of the HMO's net income before taxes (financial Statistical Report, Part 1, Line 14) that is returned to the state in accordance with Section 13.2.

Examples of Experience Rebate in a sentence

• The Experience Rebate is calculated in accordance with the tiered rebate method set forth below.

• Thus, any Experience Rebate due or paid on or after the Primary Settlement will accrue interest starting at 35 days after the due date for the 90-day FSR Report.

• If a 120-day FSR, and an Experience Rebate payment based on it, are received by HHSC before the interest commencement date above, then such a payment would be counted as part of the Primary Settlement.

• For example, any Experience Rebate payment (s) made in conjunction with the 334-day FSR, or as a result of audit findings, will accrue interest back to 35 days after the due-date for submission of the 90-day FSR.

• HHSC will calculate the Experience Rebate Reward after it has calculated the HMO’s at-risk Capitation Rate payment, as described below in Section 6.3.2.2. HHSC will calculate whether a HMO is eligible for the Experience Rebate Reward prior to the 90-day Financial Statistical Report (FSR) filing.

More Definitions of Experience Rebate

Experience Rebate means excess of allowable HMO STAR revenues over allowable HMO STAR expenses.

Experience Rebate means the amount a managed

Experience Rebate means the amount a managed care organization is required to pay the state according to the graduated rebate method described in the managed care organization ’s contract with the commission.

Experience Rebate. The portion of the STAR+PLUS MMP’s Net Income Before Taxes, if any, which is returned to HHSC in accordance with requirements in this Contract. The Experience Rebate calculation under this Contract will be separate and apart from the Experience Rebate calculation done for other contracts with HHSC. This Experience Rebate will not be included in the “consolidated basis” of other HHSC contracts. For the purposes of calculating the Experience Rebate under this Contract, Medicare Part D premium revenues, along with associated Medicare Part D costs, will be excluded. Costs under the Experience Rebate calculation are subject to the Admin Cap and the Reinsurance Cap.

Experience Rebate means the amount a

Experience Rebate means the portion of the Dental Contractor’s net income before taxes that may be returned to the State in accordance with Section 10.08 “Experience Rebate” below.

Experience Rebate means: THE PORTION OF THE HMO'S NET INCOME BEFORE TAXES (FINANCIAL STATISTICAL REPORT) THAT IS RETURNED TO THE STATE IN ACCORDANCE WITH ARTICLE 13.2.1. JOINT INTERFACE PLAN (JIP) MEANS A DOCUMENT USED TO COMMUNICATE BASIC SYSTEM INTERFACE INFORMATION OF THE TEXAS MEDICAID ADMINISTRATIVE SYSTEM (TMAS) AMONG AND ACROSS STATE TMAS CONTRACTORS AND PARTNERS SO THAT ALL ENTITIES ARE AWARE OF THE INTERFACES THAT AFFECT THEIR BUSINESS. THIS INFORMATION INCLUDES: FILE STRUCTURE, DATA ELEMENTS, FREQUENCY, MEDIA, TYPE OF FILE, RECEIVER AND SENDER OF THE FILE, AND FILE I.D. THE JIP MUST INCLUDE EACH OF THE HMOS' INTERFACES REQUIRED TO CONDUCT STATE TMAS BUSINESS. THE JIP MUST ADDRESS THE Contract Extension Amendment AMENDMENT SFY02-#01 Effective September 1, 2001 2 COORDINATION WITH EACH OF THE CONTRACTOR'S INTERFACE PARTNERS TO ENSURE THE DEVELOPMENT AND MAINTENANCE OF THE INTERFACE; AND THE TIMELY TRANSFER OF REQUIRED DATA ELEMENTS BETWEEN CONTRACTORS AND PARTNERS.