Rate Period 2 definition
Examples of Rate Period 2 in a sentence
For Service Areas where HHSC has not operated a Medicaid MCO Program prior to the Effective Date of this Contract, HHSC will establish base Capitation Rates for the Rate Periods following Rate Period 2 by analyzing the Medicaid MCO Program's historical Encounter Data and financial data for the Service Area.
Part 8 of the HHSC Managed Care Contract document, “Payment,” is modified to add the capitation rates for Rate Period 2.
The following Rate Cells and Capitation Rates will apply to Rate Period 2: STAR SSI Administrative Fee: HHSC will pay a STAR HMO a monthly Administrative Fee of $14.00 per SSI Beneficiary who voluntarily enrolls in the HMO in accordance with Attachment A, “HHSC Uniform Managed Care Contract Terms and Conditions,” Article 10.
The following Rate Cells and Capitation Rates will apply to Rate Period 2: Rate Cell Rate Period 2 Capitation Rates Delivery Supplemental Payment: See Attachment A, “HHSC Uniform Managed Care Contract Terms and Conditions,” Article 10, for a description of the methodology for establishing the Delivery Supplemental Payment for the CHIP Program.
The following Rate Cells and Capitation Rates will apply to Rate Period 2: 1.
In the establishment of Rates for Rate Period 2, due to the lack of tonnage data for a 12-month period, the tonnage of Recyclable Materials included in Contractor’s Proposal shall be used in place of the Total Tons of Recyclable Materials Collected for the most-recently completed 12-month period.
For Service Areas where HHSC has not operated the STAR Program prior to the Effective Date of this Contract, HHSC will establish base Capitation Rates for the Rate Periods following Rate Period 2 by analyzing historical STAR Encounter Data and financial data for the Service Area.
The Rate adjustment process for Rate Period 2 involves: review of “Total 2683 Contractor’s Costs”, consisting of Contractor’s actual, allowable, and Eligible Expenses from 2684 Contractor’s most recently completed Fiscal Year; review of Contractor’s projected Eligible 2685 Expenses for Rate Period 2; the calculation of allowable profit for Rate Period 2; and, the 2686 calculation of City Fees and Pass-through Expenses.
In the establishment of Rates for Rate Period 2, due to the lack of tonnage data for a 12-month period, the tonnage of Solid Waste included in Contractor’s Proposal shall be used in place of the Total Tons of Solid Waste Collected for the most-recently completed 12-month period.
At the end of Rate Period 2, HHSC will evaluate if the HMO has demonstrated that it has fully met the performance expectations for which the HMO is at risk.