Material Adjustment. An adjustment that, using reasonable actuarial judgment, has a significant impact on the development of the capitation payment such that its omission or misstatement could impact a determination whether the development of the capitation rate is consistent with generally accepted actuarial principles and practices. Medicaid: The BadgerCare Plus and Medicaid SSI Program operated by the Wisconsin Department of Health Services under Title XIX of the Federal Social Security Act, Wis. Stats., Ch. 49, and related state and federal rules and regulations. Medicaid SSI (Supplemental Security Income): Wisconsin’s Medicaid plans for the elderly, blind or disabled provide health care for members who are:

Material Adjustment. An adjustment that, using reasonable actuarial judgment, has a significant impact on the development of the nonrisk prepayment such that its omission or misstatement could impact a determination whether the development of the nonrisk prepayment rate is consistent with generally accepted actuarial principles and practices. Medical Home: The provision of care that is accessible, family-centered, continuous, comprehensive, coordinated, compassionate and culturally competent, per the American Academy of Pediatrics (AAP). The term “medical home” describes a structure and concept of coordinated medical care and is designed to provide high-quality, cost- effective health care services. The medical home is distinguished from other models of care by the provider’s level of expertise in serving children with complex needs and the fundamental commitment to address not only medical, but also psychosocial and community issues affecting the physical and emotional health of the child and family.

Material Adjustment. As defined in 42 CFR § 438.2, an adjustment that, using reasonable actuarial judgment, has a significant impact on the development of the capitation payment such that its omission or misstatement could impact a determination whether the development of the capitation rate is consistent with generally accepted actuarial principles and practices. “Medallion 4.0” A statewide mandatory Medicaid program, approved by the Centers for Medicare & Medicaid Services through a 1915(b) waiver, which utilizes contracted managed care organizations (MCOs) to provide medical services to qualified individuals. . “(Medallion 4.0) Carved-Out Services” The subset of covered services which the Contractor shall not be responsible for covering under the program.

Examples of Material Adjustment in a sentence

Shall be in accordance with Section 402.19, except the Material Adjustment Factor (MAF) shall not apply.
The Contractor must complete and submit to the Contracting Authority Form CF152, Material Adjustment Report.
Price Adjustment - a modification of the base purchase order price on the basis of increases or decreases in published or established prices of specific items.8.10.5.1.2 Labor and Material Adjustment - a modification of the contract base price on the basis of increases or decreases of wage rates, specific material costs, or both, using agreed upon standards or indices.
The third finding (2019-003) notes a Material Adjustment to the Financial Statements was needed for the District’s other postemployment plan deferred outflow asset.
Hazardous Material Adjustment Clause (Rider HMAC) base rate amount.

More Definitions of Material Adjustment

Material Adjustment. An adjustment that, using reasonable actuarial judgment, has a significant impact on the development of the capitation payment such that its omission or

Material Adjustment means an amount in excess of $1 million with respect to the Wholesale Business or $1 million with respect to the Retail Business (determined, in each case, individually or in the aggregate). If such audit results in any dispute as to whether any adjustment to the Base Purchase Price was made in accordance with this Agreement, the dispute shall be resolved pursuant to the dispute resolution provisions of Section 15.1 (and, for certainty, for the purposes of determining any applicable time periods or limitation periods for any dispute, including pursuant to Applicable Law or pursuant to the terms of this Agreement, such time period shall not commence until the completion of any audit and the results of such audit are made known to the Parties).

Material Adjustment has the meaning set forth in Section 4.10;

Material Adjustment shall have the meaning given such term in the definition of “Applicable Base Rate Margin.”

Material Adjustment. An adjustment that, using reasonable actuarial judgment, has a significant impact on the development of the capitation payment such that its omission or misstatement could impact a determination whether the development of the capitation rate is consistent with generally accepted actuarial principles and practices. Outcomes: Changes in patient health, functional status, satisfaction or goal achievement that result from health care or supportive services. Rate Cell: A set of mutually exclusive categories of enrollees that is defined by one or more characteristics for the purpose of determining the capitation rate and making a capitation payment; such characteristics may include age, gender, eligibility category, and region or geographic area. Each enrollee should be categorized in one of the rate cells for each unique set of mutually exclusive benefits under the contract.

Material Adjustment means an adjustment that has a significant impact on the development of the Capitation Payment such that its omission or misstatement could impact a determination whether the development of the Capitation Rate and is consistent with generally accepted actuarial principles and practices (XXXX). 1. 125 May in this Agreement denotes an activity, but not a mandatory requirement.