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 rate means the fee the department pays monthly to an HMO for each enrolled recipient for the provision of covered medical and health services whether or not the enrolled recipient received services during the month for which the fee is intended.
Capitation rate means the fixed monthly amount that the Contractor receives for an Enrollee to provide that Enrollee with the Benefit Package.
Examples of Capitation rate in a sentence
Final Capitation Rate Compliance The final capitation rates are in compliance with 42 CFR 438.4(b)(6) and are only based on services outlined in 42 CFR 438.3(c)(1)(ii) and 438.3(e).
The baseline Medicaid data was published on June 6, 2018, titled “July 2018 MyCare Opt-Out Capitation Rate Amendment”.
The previously certified capitation rates and the documentation of their development were published in the following correspondences provided by Milliman: • CY 2021 Medicaid Managed Care Capitation Rate Certification dated December 9, 2020 • CY 2021 Medicaid Managed Care Capitation Rate Amendment dated July 22, 2021 Throughout this report we will refer to the combination of these documents as the Original certification.
More Definitions of Capitation rate
Capitation rate means the fee the department pays monthly to the contractor for each enrolled Medicaid member for the provision of covered, required, and optional services, whether or not the enrollee received services during the month for which the fee is paid.
Capitation rate means a fixed predetermined fee paid by HHSC to the HMO each month in accordance with the Contract, for each enrolled Member in a defined Rate Cell, in exchange for the HMO arranging for or providing a defined set of Covered Services to such a Member, regardless of the amount of Covered Services used by the enrolled Member.
Capitation rate means the fixed monthly amount that the Contractor receives from the State for an Enrollee to provide that Enrollee with the Medicaid Advantage Plus Product.
Capitation rate means the monthly fee the department pays to a PACE organization for each Medicaid enrollee for the provision of covered medical and health services, whether or not the enrollee received services during the month for which the fee is intended.
Capitation rate means the actuarially sound per-enrollee, per-month amount, including any adjustments, that OHCA agrees to pay an MCO or DBM for the provision of State Plan services.
Capitation rate means the negotiated Medicaid monthly per capita amount paid to a PACE provider for all services provided to enrollees.
Capitation rate means a mode of payment which THAT the program