Monthly CMS Capitation definition

Monthly CMS Capitation refers to the monthly premium payment made by CMS to Blue Shield as payment to Blue Shield for the provision of services to the Blue Shield 65 Plus Members enrolled in Blue Shield.
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Monthly CMS Capitation refers to the monthly premium payment made by CMS to Health Plan as payment to Health Plan for the provision of services to the Blue Shield 65 Plus Enrollees enrolled in Health Plan.
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Examples of Monthly CMS Capitation in a sentence

  • Health Plan may make monthly retroactive adjustments to reflect any retroactive adjustments made by CMS to the Monthly CMS Capitation.

  • Effective Date: January 1, 2002-December 31, 2002 & thereafter until amended BLUE SHIELD 65 PLUS MEMBERS *** of the Monthly CMS Capitation received by Blue Shield from CMS and *** of the monthly premium received by Blue Shield from the Member or from an Employer Group which Blue Shield determines, according to its actuarial standards and methodology, to be for a benefit that is designated as a Shared Savings Service in Exhibit B.

  • Effective Date: January 1, 2002-December 31, 2002 & thereafter until amended BLUE SHIELD 65 PLUS MEMBERS *** of the Monthly CMS Capitation received by Blue Shield from CMS and *** of the monthly premium received by Blue Shield from the Member or from an Employer Group which Blue Shield determines, according to its actuarial standards and methodology, to be for outpatient prescription drug services.

  • HMO IPA/Medical Group Agreement PHARMACY SHARED SAVINGS FUND ALLOCATIONS PROFESSIONAL CARE IPA MEDICAL GROUP Effective Date: BLUE SHIELD 65 PLUS MEMBERS NA percent ( %) of the Monthly CMS Capitation received by Blue Shield from CMS and percent ( %) of the monthly premium received by Blue Shield from the Member or from an Employer Group which Blue Shield determines, according to its actuarial standards and methodology, to be for outpatient prescription drug services.

Related to Monthly CMS Capitation

  • 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.

  • Capitation rate means the fee the department pays monthly to a participating health or dental plan for each enrollee for the provision of covered medical or dental services whether or not the enrollee received services during the month for which the fee is intended.

  • 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.

  • Monthly Service Fee means a monthly charge to a member for continuing care and not as rent, or a daily prorated portion thereof.

  • Monthly Service Fees means the monthly (or 1/12 of the annual fee) subscription fees paid for the affected Cloud Service which did not meet the SA SLA.

  • Monthly Average means the highest allowable average of “daily discharges” over a calendar month, calculated as the sum of all “daily discharges” measured during a calendar month divided by the number of “daily discharges” measured during that month. For Fecal Coliform Bacteria (FCB) or E-Coli, report the monthly average.

  • Monthly Charges means a finance carrying charge of one and one-half of one percent (1.5%) and a storage and handling charge of one-half of one percent (0.5%), in each case of the Cost of the Inventory and/or Special Inventory and/or of the fees for the Product affected by the reschedule or cancellation (as applicable) per month until such Inventory and/or Special Inventory and/or Product is returned to the vendor, used to manufacture Product or is otherwise purchased by Customer.

  • Monthly Salary Rate means the amount agreed to by the Owner that can be used on Applications for Payment throughout the Construction Phase to account for the services of Construction Manager’s salaried personnel assigned to the Project. A Monthly Salary Rate must be established for each salaried person and must be approved in writing by the Owner in advance of any Application for Payment for that person. The Monthly Salary Rate is for convenience only and any payments made for Construction Manager’s personnel are subject to audit to determine the actual cost of the wages and allowable employer contributions incurred by the Construction Manager for services performed for the Project.

  • Monthly Loss Amount means the sum of all Foreclosure Losses, Restructuring Losses, Short Sale Losses, Portfolio Losses, Modification Default Losses and Deficient Losses realized by the Assuming Institution for any Shared Loss Month.

  • Three-Month Secondary CD Rate means, for any day, the secondary market rate for three-month certificates of deposit reported as being in effect on such day (or, if such day is not a Business Day, the next preceding Business Day) by the Board through the public information telephone line of the Federal Reserve Bank of New York (which rate will, under the current practices of the Board, be published in Federal Reserve Statistical Release H.15(519) during the week following such day) or, if such rate is not so reported on such day or such next preceding Business Day, the average of the secondary market quotations for three-month certificates of deposit of major money center banks in New York City received at approximately 10:00 a.m., New York City time, on such day (or, if such day is not a Business Day, on the next preceding Business Day) by the Administrative Agent from three negotiable certificate of deposit dealers of recognized standing selected by it.

  • Total Service Charges means all charges, after application of all discounts and credits, for Services excluding Taxes, Governmental Charges, equipment, Company ILEC, Company Wireless, Document Delivery Fax, non-recurring, goods and services acquired by Company as Customer’s agent, international pass-through access (Type 3/PTT) and charges for international access or provided by Company (Type 1), charges for security services provided by Cybertrust, Inc. or its affiliates set forth in the Guide as providers of Cybertrust security services and other charges expressly excluded by this Agreement.

  • Highest Average Compensation means the average Compensation for the three (3) consecutive years of Service with the Employer that produces the highest average. A Year of Service with the Employer is the twelve (12) consecutive month period identical to the Plan Year.