Capitation Rate Clause Samples

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Capitation Rate. The base Capitation Rate will be $186.29 per patient per fiscal year and will change in the future according to negotiated changes for Family Medicine fee codes in the Memorandum of Agreement. The Capitation Rate will be adjusted for each Attached patient according to the table appended to this Schedule (Appendix A). The table may be adjusted from time to time on the written agreement of the parties.
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Capitation Rate. For Capitated Services, PPG shall be compensated for rendering professional In-Nctwork Services to Medicare POS Members at the percent of Monthly Revenue for Medicare HMO Members as set forth in this Addendum C, less a *** withhold (Professional Out-of-Network Withhold), for each Medicare POS Member eligible to receive such services from PPG during any particular month. In the event PPG’s enrollment exceeds *** Medicare POS Members, the Professional Out-of-Network Withhold percentage shall be equal to (i) PPG’s prior year’s professional Out-of-Network costs, divided by the total of PPG’s Capitation for Medicare POS Members (prior to the Professional Out-of-Network Withhold) rounded to the nearest multiple of five, ***, or (ii) *** if there is no prior year experience or if PPG has *** less Medicare POS Members. On or before December 15th of each year, HMO shall notify PPG of PPG’s Out-of-Network experience incurred between July 1 of the previous year and June 30 of the current year and the calculation noted above, and such shall be PPG’s Professional Out-of-Network Withhold percentage for the following year. Capitation shall be calculated on the basis of the most current information available and shall be paid by HMO by wire transfer on or before the fifteenth (15th) day of each month, or the first business day following the fifteenth if the fifteenth is a holiday or on a weekend, or within two (2) days of HCFA’s payment to HMO, whichever is later. Each Capitation payment shall be accompanied by a remittance summary. The remittance summary identifies the total Capitation payable and those Medicare POS Members for whom Capitation is being paid. In the event of a Capitation error, resulting in an overpayment or underpayment to PPG, HMO shall adjust subsequent Capitation to offset such error.
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Capitation Rate. The Capitation rate for fiscal years 2006 and 2007 will consist of separately calculated elements as outlined below: 1. The Medical Services capitation will be calculated on a rate per inmate per day based on a guaranteed sector population of 120,300. For TDCJ offender populations above 117,894 but less than or equal to 122,706, UTMB agrees to deliver Medical Services at no additional costs. If for two consecutive months, the UTMB sector offender population falls below or rises above the population range specified in this paragraph, an adjusted Medical Services capitation will be negotiated by mutual agreement of the parties and shall be based on actual documented costs. For both Fiscal Year 2006 and Fiscal Year 2007 the Medical Services capitation rate shall be $6.235. 2. The Mental Health Services capitation payments shall be based on the performance factors and rates outlined below: a) Psychiatric Inpatient Services Capitation rate shall be $30.00 per inpatient per day based as follows: Skyview Unit: 500 Jester IV Unit: 500 b) Mentally Retarded Offender Program (MROP) Capitation rate shall be $ 9.00 per offender enrolled in MROP per day based as follows: ▇▇▇▇▇ Unit: 710 c) Psychiatric Outpatient Services Capitation rate shall be $2.60 per outpatient per day based on outpatient caseloads as follows: FY 2006 and FY 2007: 13,000
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Capitation Rate. The Capitation rate for fiscal years 2010 and 2011 will consist of separately calculated elements as outlined below: 1. The Medical Services capitation will be calculated on a rate per inmate per day based on a guaranteed sector population of 120,180. For TDCJ offender populations above 115,372 but less than or equal to 124,987, ▇▇▇▇ agrees to deliver Medical Services at no additional costs. If for two consecutive months, the UTMB sector offender population falls below or rises above the population range specified in this paragraph, an adjusted Medical Services capitation will be negotiated by mutual agreement of the parties and shall be based on actual documented costs. The Medical Services capitation rate shall be: $7.7049 in FY 2010; and, $7.6388 in FY 2011. 2. The Mental Health Services capitation payments shall be calculated using the same guaranteed sector population and population ranges as outlined in paragraph III.B.1 above. The Mental Health Services capitation rate shall be: $0.6402 in FY 2010; and, $0.6402 in FY 2011. It is that intent of the parties that the Mental Health Services capitation provides for the following approximate levels of service: a. Psychiatric Inpatient Services average census of 1,015 offender patients. b. Mentally Retarded Offender Program (MROP) average census of 710 offender patients. c. Psychiatric Outpatient Services average caseload of 15,000 offender patients. 3. In Fiscal Year 2011, contingent upon completion of renovations to the ▇▇▇▇▇▇ Medical Facility: a. Startup equipment funding in the amount of $773,000 to be paid September 15th or 60 days prior to the anticipated occupancy date whichever is later; and, b. Annual operating funding in the amount of $4,070,986, to be paid in quarterly installments in conjunction with the payments as follows; Date Payment is Due Amount Due The above amounts assume a September 1, 2010 occupancy date. Should the occupancy date occur later than that date, the amount of such payments shall be prorated based on the actual occupancy date.
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Capitation Rate. The Capitation rate for fiscal years 2010 and 2011 will consist of separately calculated elements as outlined below: 1. The Medical Services capitation will be calculated on a rate per inmate per day based on a guaranteed sector population of 31,554. For TDCJ offender populations above 30,291 but less than or equal to 32,816, TTUHSC agrees to deliver Medical Services at no additional costs. If for two consecutive months, the TTUHSC sector offender population falls below or rises above the population range specified in this paragraph, an adjusted Medical Services capitation will be negotiated by mutual agreement of the parties and shall be based on actual documented costs. The Medical Services capitation rate shall be: $7.4973 in FY 2010; and, $7.4963 in FY 2011. 2. The Mental Health Services capitation payments shall be calculated using the same guaranteed sector population and population ranges as outlined in paragraph III.B.1 above. The Mental Health Services capitation rate shall be: $1.1537 in FY 2010; and, $1. 1537 in FY 2011. It is that intent of the parties that the Mental Health Services capitation provides for the following approximate level of service: a. Psychiatric Inpatient Services average census of 523 offender patients. b. Program for the Aggressive Mentally-Ill Offender (PAMIO) average census of 425 offender patients. c. Psychiatric Outpatient Services average caseload of 4,200 offender patients.
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Capitation Rate. The amount to be paid to APS for each Enrollee per month that is specified in and adjusted by Attachment A to this Agreement.
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Capitation Rate. PPG shall be compensated for rendering professional In-Network Services to Medicare POS Members at the percent of Monthly Revenue for Medicare HMO Members as set forth in this Addendum C, less a *** withhold (Professional Out-of-Network Withhold), for each Medicare POS Member eligible to receive such services from PPG during any particular month. Effective September 1, 2001 PPG shall be compensated for rendering professional In-Network Services to Medicare POS Members at the percent of Monthly Revenue for Medicare HMO Members as set forth in this Addendum C, less a zero (0.0%) withhold (Professional Out-of-Network Withhold), for each Medicare POS Member eligible to receive such services from PPG during any particular month. Capitation shall be calculated on the basis of the most current information available and shall be paid by HMO by wire transfer on or before the fifteenth (15th) day of each month, or the first business day following the fifteenth if the fifteenth is a holiday or on a weekend, or within two (2) days of HCFA’s payment to HMO, whichever is later. Each Capitation payment shall be accompanied by a remittance summary. The remittance summary identifies the total Capitation payable and those Medicare POS Members for whom Capitation is being paid. In the event of a Capitation error, resulting in an overpayment or underpayment to PPG, HMO shall adjust subsequent Capitation to offset such error.
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Related to Capitation Rate

  • SALARY RATES Section 12.1 The following shall apply to full-time employees including so called TPL A and B: A. Effective the first full pay period of July, 2017, employees who meet the eligibility criteria provided in Section 2 of this Article shall receive a one percent (1%) increase in salary rate. B. Effective the first full pay period of July, 2017, employees who meet the eligibility criteria provided in Section 2 of this Article shall receive an additional one percent (1%) increase in salary rate due to the realization of the FY’18 tax revenue trigger threshold. C. Effective the first full pay period of July, 2018, employees who meet the eligibility criteria provided in Section 2 of this Article shall receive a two percent (2%) increase in salary rate. D. Effective the first full pay period of July, 2019, employees who meet the eligibility criteria provided in Section 2 of this Article shall receive a two percent (2%) increase in salary rate. Section 12.2 Employees who receive a "Below" rating on their annual EPRS evaluation shall not be eligible to receive the salary increases provided in Section 1 of this Article, nor any step increases. Employees who receive a "Below" rating will have their performance reviewed on a monthly basis in accordance with Article 24A of this Agreement and will become eligible for the salary and step rate increase previously denied effective upon the date of receiving a "Meets" or "Exceeds" rating. Section 12.3 The salary rate for new employees hired, reinstated or re-employed on or after July 1, 1990 shall be Step 1 for the job group of his/her position except in cases where a new employee is hired by a Department/Agency at a salary rate, approved by the Chief Human Resources Officer, above Step 1. However, new employees shall not be recruited into Unit 3 positions without the prior written agreement of the Union. A. Under the terms of this Agreement, an employee shall advance to the next higher salary step in his/her job group until the maximum salary rate is reached, unless he/she is denied such step rate by his/her Appointing Authority. An employee shall progress from one step to the next higher step after each fifty-two (52) weeks of creditable service in a step commencing from the first day of the payroll period immediately following his/her anniversary date. B. In the event an employee is denied a step rate increase by his/her Appointing Authority, he/she shall be given a written statement of reasons therefore not later than five (5) days preceding the date when the increase would otherwise have taken effect. Time off the payroll is not creditable service for the purpose of step rate increases. Section 12.5 Whenever an employee paid in accordance with the salary schedules provided in Appendix A of this Agreement receives a promotion to a higher job group, the employee's new salary rate shall be calculated as follows: 1. For employees who are below the maximum step within their current job: a. Determine the employee’s current salary rate and step within his/her current job group; then b. Find the salary rate of the next higher step within the employee’s current job group; and c. Multiply the employee’s current salary rate by one and three one- hundredths (1.03); then d. Compare the higher of the resultant amounts from b) or c) above to the salary rates for the higher job group into which the employee is being promoted. e. The employee’s salary rate shall be the first rate in the higher job group that at least equals the higher of the resultant amounts from d) above. f. In the event the application of the above formula results in a salary that is less than the amount the employee would receive had he/she been promoted to the next lower grade, the employee’s salary upon promotion shall be increased to the next higher step in the grade the employee is being promoted into. 2. For employees who are at the maximum step within their current job: a. Determine the employee’s current salary rate and step within his/her current job group; then, b. Multiply the employee’s current salary rate by one and three one- hundredths (1.03); then, c. Compare the resultant amount from b) above to the salary rates for the higher job group into which the employee is being promoted. d. The employee’s salary rate shall be the first rate in the higher job group that at least equals the resultant amount from c) above. A. Salary rates of full time employees are set forth in Appendix A of this Agreement, which is attached hereto and is hereby made a part of this Agreement. B. The salary rates set forth in Appendix A shall remain in effect during the term of this agreement. Salary rates shall not be increased or decreased except in accordance with the provisions of this Agreement. C. Employees shall be compensated on the basis of the salary rate for their official job classification. Section 12.7 A regular part-time employee shall be entitled to the provisions of this Article in the proportion that his/her service bears to full-time service. A. An employee entering a position within a bargaining unit covered by this Agreement from a position in an equivalent salary grade in a bargaining unit not covered by this Agreement shall be placed at the first step-in-grade up to the maximum of the grade, which at least equals the rate of compensation received immediately prior to his/her entry into the bargaining unit.

  • Accrual Rates All eligible employees shall accrue vacation pay according to the following rates:

  • Salary Ranges A. The salary ranges for classifications covered by this Agreement shall be those contained in Appendix D. B. No one may be hired above or below the assigned salary range for his/her classification. Employees whose salaries are above the range assigned to their classification will have their salaries frozen until the salary range increases to include their salary.

  • Accrual Rate Compensatory time for employees will accrue at the rate of one and one-half hours for each one hour of overtime worked.

  • APR The Annual Percentage Rate of such Receivable ranges from 0.00% to 11.99%.