One Time Adjustment for 2003 Increases in Secure Horizons Revenue Sample Clauses

One Time Adjustment for 2003 Increases in Secure Horizons Revenue. The Capitation Percentage set forth in section 3.1 above assumes a prospective Secure Horizons Revenue increase effective as of January 1, 2003, of no greater than *** over the average Secure Horizons Revenue for Assigned Medical Group Members for calendar year 2002 (the “Annual Increase”). Such assumption is based upon the estimated average payment rates for Medicare Parts A and B overall for calendar year 2003 as published by CMS in March 2003. In the event that the actual Annual Increase is more than three percent (3%), as determined by law or legislative or regulatory action or federal administrative agency interpretation no later than December 31, 2002 (as calculated by PacifiCare for Secure Horizons Members), the increase shall be used by PacifiCare to enhance market competitiveness and/or improve Secure Horizons Plan benefits. PacifiCare shall reduce the Capitation Percentage to an amount that will adjust Medical Group’s Standard Service Capitation Payments to reflect the *** agreed limit on the Annual Increase in Secure Horizons Revenue under this Agreement However increases to Medical Group’s SHIP Budget shall not be limited unless otherwise agreed by PacifiCare and Medical Group. The resulting adjustment, if any, in the Capitation Percentage shall begin with the January 2003 Standard Service Capitation Payment. This provision will be in effect for the term of this Agreement.
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One Time Adjustment for 2003 Increases in Secure Horizons Revenue. The Capitation Percentage set forth above assumes a prospective Secure Horizons Revenue increase effective as of January 1, 2003, of no greater than *** over the average Secure Horizons Revenue for Assigned Medical Group Members for calendar year 2002 (the “Annual Increase”). In the event that the actual Annual Increase is more than ***, as determined by law or legislative or regulatory action or federal administrative agency interpretation no later than December 31, 2002 (as calculated by PacifiCare for Assigned Medical Group Members) the increase shall be used to enhance market competitiveness and/or improve Secure Horizons Plan benefits. PacifiCare shall reduce the Capitation Percentage to an amount that will adjust Medical Group’s Standard Service Capitation Payments to reflect the *** agreed limit on the Annual Increase in Secure Horizons Revenue under this Agreement. The resulting adjustment, if any, in the Capitation Percentage shall begin with the January 2003 Standard Service Capitation Payment.

Related to One Time Adjustment for 2003 Increases in Secure Horizons Revenue

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