DATA RELIANCE Clause Samples
POPULAR SAMPLE Copied 1 times
DATA RELIANCE. In developing the CY 2008 ABD capitation rates, we have relied upon certain data and information from ODJFS. While limited review was performed for reasonableness, the data and information was accepted without audit. To the extent that the data and information was not accurate or complete, the values shown in this letter will need to be revised. u u u u If you have any questions regarding the enclosed information, please do not hesitate to contact me at (▇▇▇) ▇▇▇-▇▇▇▇. Sincerely, R▇▇▇▇▇ ▇. ▇▇▇▇▇▇, FSA, MAAA Principal and Consulting Actuary RMD/mle cc: D▇▇ ▇▇▇▇▇ (ODJFS) M▇▇▇▇▇ ▇▇▇▇▇▇ (ODJFS) R▇▇▇▇▇ ▇▇▇▇▇ (ODJFS) Milliman makes no representations or warranties regarding the contents of this letter to third parties. Likewise, third parties are instructed that they are to place no reliance upon this letter prepared for ODJFS by Milliman that would result in the creation of any duty or liability under any theory of law by Milliman or its employees to third parties. Other parties receiving this letter must rely upon their own experts in drawing conclusions about the information presented. Milliman makes no representations or warranties regarding the contents of this letter to third parties. Likewise, third parties are instructed that they are to place no reliance upon this letter prepared for ODJFS by Milliman that would result in the creation of any duty or liability under any theory of law by Milliman or its employees to third parties. Other parties receiving this letter must rely upon their own experts in drawing conclusions about the information presented.
DATA RELIANCE. In developing the CY 2008 ABD capitation rates, we have relied upon certain data and information from ODJFS. While limited review was performed for reasonableness, the data and information was accepted without audit. To the extent that the data and information was not accurate or complete, the values shown in this letter will need to be revised. If you have any questions regarding the enclosed information, please do not hesitate to contact me at (▇▇▇) ▇▇▇-▇▇▇▇. Sincerely, ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇, FSA, MAAA Principal and Consulting Actuary RMD/mle cc: ▇▇▇ ▇▇▇▇▇ (ODJFS) ▇▇▇▇▇▇ ▇▇▇▇▇▇ (ODJFS) ▇▇▇▇▇▇ ▇▇▇▇▇ (ODJFS) FINAL and CONFIDENTIAL I, ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇, am a Principal and Consulting Actuary with the firm of ▇▇▇▇▇▇▇▇, Inc. I am a Fellow of the Society of Actuaries and a Member of the American Academy of Actuaries. I was retained by the State of Ohio, Department of Job and Family Services to perform an actuarial review and certification regarding the development of the capitation rates to be effective for calendar year 2008. The capitation rates were developed for the Aged, Blind, or Disabled managed care eligible populations. I have experience in the examination of financial calculations for Medicaid programs and meet the qualification standards for rendering this opinion. I reviewed the historical claims experience for reasonableness and consistency. I have developed certain actuarial assumptions and actuarial methodologies regarding the projection of healthcare expenditures into future periods. I have complied with the elements of the rate setting checklist CMS developed for its Regional Offices regarding 42 CFR 438.6(c) for capitated Medicaid managed care plans. The capitation rates provided with this certification are effective for a one-year rating period beginning January 1, 2008 through December 31, 2008. At the end of the one-year period, the capitation rates will be updated for calendar year 2009. The update may be based on fee-for-service experience, managed care utilization and trend experience, policy and procedure changes, and other changes in the health care market. A separate certification will be provided with the updated rates. The capitation rates provided with this certification are considered actuarially sound, defined as: • the capitation rates have been developed in accordance with generally accepted actuarial principles and practices; • the capitation rates are appropriate for the populations to be covered, and the services to be furnished u...
DATA RELIANCE. Company will provide data to Milliman, as requested by Milliman. This data includes the demographic and geographic information about Medicare-eligible beneficiaries, historical plan experience when requested, contributions, and description of retiree pharmacy benefit plans.