Medicaid Rate Calculation Sample Clauses

Medicaid Rate Calculation. The Medicaid financing strategy used by the MDHHS, as stated in the 1115 Waiver, is to contain the growth of Medicaid expenditures, not to create savings. The Medicaid Rate Calculation is based on the actuarial documentation letter from Milliman USA. Five sets of rate calculations are required: 1) one set of factors for the 1115 state plan and 1915(i) [formerly (b)(3)] services; 2) one set of factors for 1915 (c) Habilitation Supports Waiver services; 3) one set of factors for 1915 (c) Children’s Waiver Program services; 4) one set of factors for 1915 (c) Waiver for Children with Serious Emotional Disturbances; 5) one set of factors for the 1115 Healthy Michigan Plan. The Milliman USA letter documents the calculation rate methodology and provides the required certification regarding actuarial soundness as required by the Balanced Budget Act Rules effective
Sample 1Sample 2Sample 3See All (5)
AutoNDA by SimpleDocs
Medicaid Rate Calculation. The Medicaid financing strategy used by the MDCH, and stated in the 1915(b) Waiver, is to contain the growth of Medicaid expenditures, not to create savings. The Medicaid Rate Calculation is based on the actuarial documentation letter from Milliman USA. Two sets of rate calculations are required: 1) one set of factors for the 1915(b) state plan and 1915(b)(3) services and 2) one set of factors for 1915 (c) Habilitation Supports Waiver services. The capitation rates for FY 2011 are based on recipients with scope/coverage codes 1D/2D/1F/2F/1K/2K/1P/1T/2T, The Milliman USA letter documents the calculation rate methodology and provides the required certification regarding actuarial soundness as required by the Balanced Budget Act Rules effective August 13, 2002. The chart of rates and factors contained in the actuarial documentation is included as Attachment P.7.0.1. Several groups of Medicaid eligibles are excluded from the capitation methodology/payments. The groups are identified in sections 7.4.1.3 and
Sample 1Sample 2Sample 3
Medicaid Rate Calculation. The Medicaid financing strategy used by the MDCH, and stated in the 1915(b) Waiver, is to contain the growth of Medicaid expenditures, not to create savings. The Medicaid Rate Calculation is based on the actuarial documentation letter from Milliman USA. Two sets of rate calculations are required: 1) one set of factors for the 1915(b) state plan and 1915(b)(3) services and 2) one set of factors for 1915 (c) Habilitation Supports Waiver services. The capitation rates for FY 2014 are based on recipients with scope/coverage codes 1D/2D/1F/2F/1K/2K/1P/1T/2T, The Milliman USA letter documents the calculation rate methodology and provides the required certification regarding actuarial soundness as required by the Balanced Budget Act Rules effective August 13, 2002. The chart of rates and factors contained in the actuarial documentation is included as Attachment P.7.0.1.
Sample 1
Medicaid Rate Calculation. The Medicaid financing strategy used by the MDCH, and stated in the 1915(b) Waiver, is to contain the growth of Medicaid expenditures, not to create savings The Medicaid Rate Calculation is based on the actuarial documentation letter from Milliman USA. Two sets of rate calculations are required: 1) one set of factors for the 1915(b) state plan and 1915(b)(3) services and 2) one set of factors for 1915 (c) Habilitation Supports Waiver services. The capitation rates for FY 2010 are based on recipients with scope/coverage codes 1D/2D/1F/2F/1K/2K/1P/1T/2T, The Milliman USA letter documents the calculation rate methodology and provides the required certification regarding actuarial soundness as required by the Balanced Budget Act Rules effective August 13, 2002. The chart of rates and factors contained in the actuarial documentation is included as Attachment P.7.0.1. Two groups of Medicaid eligibles are excluded from the capitation methodology/payments. These are the eligibles enrolled in the Children’s waiver (approximately 400 persons) and people residing in a state center for developmental disabilities who remain in ICF-MR Medicaid funding. In addition, the rate calculations and payments excluded eligibility months associated with periods of retro-eligibility including persons who are on a monthly spend-down. While these eligible months are excluded the rates calculation included FY 98 retro costs. The PIHP is responsible for service to these individuals and may use their Medicaid funding for such services, except for that period of time each month prior to when the individual is spent-down.
Sample 1

Related to Medicaid Rate Calculation

  • Overtime Calculation For the purpose of overtime calculation only, approved or scheduled time off work will be considered the same as time worked.

  • Interest Rates and Letter of Credit Fee Rates Payments and Calculations Interest Rates. (I) Except as provided in Section 2.6(c), all Obligations (except for undrawn Letters of Credit and Term Obligations) that have been charged to the Loan Account pursuant to the terms hereof shall bear interest on the Daily Balance thereof (from the date of incurrence through but excluding the date of repayment or prepayment (whether by acceleration or otherwise)) as follows: if the relevant Obligation is a LIBOR Rate Loan denominated in Dollars, at a per annum rate equal to the LIBOR Rate plus the Applicable Margin for LIBOR Rate Loans, if the relevant Obligation is a LIBOR Rate Loan denominated in Euros, at a per annum rate equal to the LIBOR Rate plus the Applicable Margin for LIBOR Rate Loans, if the relevant Obligation is a Swingline Loan, a per annum rate equal to the overnight LIBO Rate plus its Applicable Margin for Overnight LIBO Loans, and otherwise in respect of Revolver Obligations, at a per annum rate equal to the Base Rate plus the Applicable Margin for Base Rate Loans.

  • Interest Rates Payments and Calculations (a) Interest Rate. -------------

  • Notification of rates of interest The Agent shall promptly notify the Lenders and the Borrower of the determination of a rate of interest under this Agreement.

  • Offense Level Calculations i. The base offense level is 7, pursuant to Guideline § 2B1.1(a)(1).

  • Determination of One-Month LIBOR Pursuant to the terms of the Global Agency Agreement, the Global Agent shall calculate the Class Coupons for the applicable Classes of Notes (including MAC Notes on which the Exchange Administrator has directed the Global Agent to make payments) for each Accrual Period (after the first Accrual Period) on the applicable LIBOR Adjustment Date. “One-Month LIBOR” will be determined by using the “Interest Settlement Rate” for U.S. dollar deposits with a maturity of one month set by ICE Benchmark Administration Limited (“ICE”) as of 11:00 a.m. (London time) on the LIBOR Adjustment Date (the “ICE Method”). ICE’s Interest Settlement Rates are currently displayed on Bloomberg L.P.’s page “BBAM.” That page, or any other page that may replace page BBAM on that service or any other service that ICE nominates as the information vendor to display the ICE’s Interest Settlement Rates for deposits in U.S. dollars, is a “Designated Page.” ICE’s Interest Settlement Rates currently are rounded to five decimal places. If ICE’s Interest Settlement Rate does not appear on the Designated Page as of 11:00 a.m. (London time) on a LIBOR Adjustment Date, or if the Designated Page is not then available, One-Month LIBOR for that date will be the most recently published Interest Settlement Rate. If ICE no longer sets an Interest Settlement Rate, Freddie Mac will designate an alternative index that has performed, or that Freddie Mac (or its agent) expects to perform, in a manner substantially similar to ICE’s Interest Settlement Rate.

  • Calculation of Overtime If the overtime work has been carried out before as well as after the regular working hours during a certain day, the overtime periods shall be added together. Only full half hours are included in the calculation.

  • Certain Calculations Unless otherwise specified herein, the following provisions shall apply:

  • VALUATION SUPPORT AND COMPUTATION ACCOUNTING SERVICES BNY Mellon shall provide the following valuation support and computation accounting services for each Fund: § Journalize investment, capital share and income and expense activities; § Maintain individual ledgers for investment securities; § Maintain historical tax lots for each security; § Corporate action processing as more fully set forth in the SLDs; § Reconcile cash and investment balances of each Fund with the Fund’s custodian or other counterparties as applicable; § Provide a Fund’s investment adviser, as applicable, with the cash balance available for investment purposes at start-of-day and upon request, as agreed by the parties; § Calculate capital gains and losses; § Calculate daily distribution rate per share; § Determine net income; § Obtain security market quotes and currency exchange rates from pricing services approved by a Fund’s investment adviser, or if such quotes are unavailable, then obtain such prices from the Fund’s investment adviser, and in either case, calculate the market value of each Fund’s investments in accordance with the Fund's valuation policies or guidelines; provided, however, that BNY Mellon shall not under any circumstances be under a duty to independently price or value any of the Fund's investments, including securities lending related cash collateral investments (with the exception of the services provided hereunder to Funds utilized for such cash collateral investments), itself or to confirm or validate any information or valuation provided by the investment adviser or any other pricing source, nor shall BNY Mellon have any liability relating to inaccuracies or otherwise with respect to such information or valuations; notwithstanding the foregoing, BNY Mellon shall follow the established procedures and controls to identify exceptions, tolerance breaches, etc. and to research and resolve or escalate any pricing inaccuracies; § Application of the established automated price validation rules against prices received from third party vendors and review of exceptions as identified; § Calculate Net Asset Value in the manner specified in the Fund’s Offering Materials (which, for the service described herein, shall include the Fund’s Net Asset Value error policy); § Calculate Accumulated Unit Values (“AUV”) for select funds as mutually agreed upon between the parties; § Transmit or make available a copy of the daily portfolio valuation to a Fund’s investment adviser; § Calculate yields, portfolio dollar-weighted average maturity and dollar-weighted average life as applicable; and § Calculate portfolio turnover rate for inclusion in the annual and semi-annual shareholder reports. § For money market funds, obtain security market quotes and calculate the market-value Net Asset Value in accordance with the Fund’s valuation policies and guidelines at such times and frequencies as required by regulation and/or instruction from TRP.

  • Certain Calculations and Tests (a) Notwithstanding anything in this Agreement or any Loan Document to the contrary, when calculating any applicable ratio or determining other compliance with this Agreement (including the determination of compliance with any provision of this Agreement which requires that no Default or Event of Default has occurred, is continuing or would result therefrom) in connection with a Specified Transaction undertaken in connection with the consummation of a Limited Condition Acquisition, the date of determination of such ratio and determination of whether any Default or Event of Default has occurred, is continuing or would result therefrom or other applicable covenant shall, at the option of the Borrower (the Borrower’s election to exercise such option in connection with any Limited Condition Acquisition, an “LCA Election”), be deemed to be the date the definitive agreements for such Limited Condition Acquisition are entered into (the “LCA Test Date”) and if, after such ratios and other provisions are measured on a Pro Forma Basis after giving effect to such Limited Condition Acquisition and the other Specified Transactions to be entered into in connection therewith (including any incurrence of Indebtedness and the use of proceeds thereof) as if they occurred at the beginning of the four consecutive fiscal quarter period being used to calculate such financial ratio ending prior to the LCA Test Date, the Borrower could have taken such action on the relevant LCA Test Date in compliance with such ratios and provisions, such provisions shall be deemed to have been complied with. For the avoidance of doubt, (x) if any of such ratios are exceeded as a result of fluctuations in such ratio (including due to fluctuations in Consolidated EBITDA of the Borrower) at or prior to the consummation of the relevant Limited Condition Acquisition, such ratios and other provisions will not be deemed to have been exceeded as a result of such fluctuations solely for purposes of determining whether the Limited Condition Acquisition is permitted hereunder and (y) such ratios and other provisions shall not be tested at the time of consummation of such Limited Condition Acquisition or related Specified Transactions. If the Borrower has made an LCA Election for any Limited Condition Acquisition, then in connection with any subsequent calculation of any ratio or basket availability with respect to any other Specified Transaction on or following the relevant LCA Test Date and prior to the earlier of the date on which such Limited Condition Acquisition is consummated or the date that the definitive agreement for such Limited Condition Acquisition is terminated or expires without consummation of such Limited Condition Acquisition, any such ratio or basket shall be calculated on a Pro Forma Basis assuming such Limited Condition Acquisition and other transactions in connection therewith (including any incurrence of Indebtedness and the use of proceeds thereof) have been consummated; provided, that (other than solely with respect to the incurrence test under which such Limited Condition Acquisition is being made) Consolidated EBITDA, Consolidated Total Assets or assets and Consolidated Net Income of any target of such Limited Condition Acquisition can only be used in the determination of the relevant ratio and baskets if and when such Limited Condition Acquisition has closed.

Time is Money Join Law Insider Premium to draft better contracts faster.