Prospective Program Adjustments Sample Clauses

Prospective Program Adjustments. The SFY 2008/2009 Budget contains several program changes that impacted the development of the capitation rates. The program changes include items such as provider fee changes, benefit changes, and administrative changes. Adjustments to the CY 2006 experience were developed for each item based on its expected impact to the prospective claims cost. Table 8 lists the program changes that were included in the CY 2008 capitation rate development. 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. Mx. Xxx Xxxxxx, Ph.D. December 12, 2007 Page 17 FINAL and CONFIDENTIAL Table 8 STATE OF OHIO DEPARTMENT OF JOB AND FAMILY SERVICES Prospective Program Adjustments Effective Service Program Adjustment Date Category(s) Rate Groups Nursing Facility Fee Increase 7/1/2007 7/1/2008 Nursing Facility All Rate Groups (excl. Delivery) Chiropractor Benefit Restoration 1/1/2008 Miscellaneous Services HF M — 19 to 44 HF F — 19 to 44 HF M/F — 45 to 64 HST F — 19 to 64 Independent Psychologists Benefit Restoration 1/1/2008 Mental Health / Substance Abuse HF M — 19 to 44 HF F — 19 to 44 HF M/F — 45 to 64 HST F — 19 to 64 Occupational Therapy-Independent Provider Status 1/1/2008 Miscellaneous Services All Rate Groups (excl. Delivery) Developmental Therapies 1/1/2008 Miscellaneous Services HST M/F — <1 Fxxxxx Children Expansion 1/1/2008 All Service Categories HST M — 14 to 18 HST F — 14 to 18 CHIP III Expansion 1/1/2008 All Service Categories HF M — 19 to 44 HF F — 19 to 44 HST F — 19 to 64 HST M/F — 2 to l3 HST M — 14 to 18 Pregnant Women Expansion 1/1/2008 All Service Categories HST F — 14 to 18 HST F — 19 to 64 Delivery Improved TPL Management 1/1/2008 All Service Categories All Rate Groups (incl. Delivery) Expedite Managed Care Enrollment 1/1/2008 All Service Categories All Rate Groups (incl. Delivery) Expedite Newborn Enrollment 1/1/2008 All Service Categories HST M/F — <1 Short Term Nursing Facility Policy Change (consistent with ABD) 1/1/2008 Nursing Facility All Rate Groups (excl. Delivery) Prior Authorization Policy Change 1/1/2008 Pharmacy All Rate Group...
Sample 1
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Prospective Program Adjustments. The SFY 2008/2009 Budget contains several program changes that impacted the development of the capitation rates. The program changes include items such as provider fee changes, benefit changes, and administrative changes. Adjustments to the CY 2006 experience were developed for each item based on its expected impact to the prospective claims cost. Table 5 lists the program changes that were included in the CY 2008 capitation rate development. 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. Mx. Xxx Xxxxxx, Ph.D. December 12, 2007 Page 10 FINAL and CONFIDENTIAL Table 5 STATE OF OHIO DEPARTMENT OF JOB AND FAMILY SERVICES Prospective Program Adjustments Effective Program Adjustment Date Service Category(s) Nursing Facility Fee Increase 7/1/2007 Nursing Facility 7/1/2008 Chiropractor Benefit Restoration 1/1/2008 Miscellaneous Services Independent Psychologists Benefit Restoration 1/1/2008 Mental Health / Substance Abuse Occupational Therapy-Independent Provider Status 1/1/2008 Miscellaneous Services Improved TPL Management 1/1/2008 All Service Categories Prior Authorization Policy Change 1/1/2008 Pharmacy Prior Authorization of Atypical Anti-Psychotic Medication 1/1/2008 Pharmacy
Sample 1

Related to Prospective Program Adjustments

  • Performance Adjustment One-twelfth of the annual Performance Adjustment Rate will be applied to the average of the net assets of the Portfolio (computed in the manner set forth in the Fund's Declaration of Trust or other organizational document) determined as of the close of business on each business day throughout the month and the performance period.

  • Downward Adjustments The Purchase Price shall be adjusted downward by the following:

  • Stock Adjustments In the event that during the term of the pledge any stock dividend, reclassification, readjustment or other changes are declared or made in the capital structure of Pledgee, all new, substituted and additional shares or other securities issued by reason of any such change shall be delivered to and held by the Pledgee under the terms of this Security Agreement in the same manner as the Shares originally pledged hereunder. In the event of substitution of such securities, Pledgor, Pledgee and Pledgeholder shall cooperate and execute such documents as are reasonable so as to provide for the substitution of such Collateral and, upon such substitution, references to "Shares" in this Security Agreement shall include the substituted shares of capital stock of Pledgor as a result thereof.

  • True-Up Adjustments From time to time, until the Retirement of the Recovery Bonds, the Servicer shall identify the need for True-Up Adjustments and shall take all reasonable action to obtain and implement such True-Up Adjustments, all in accordance with the following:

  • Adjustments to Prevent Dilution In the event that the Company changes the number of Shares or securities convertible or exchangeable into or exercisable for Shares issued and outstanding prior to the Effective Time as a result of a reclassification, stock split (including a reverse stock split), stock dividend or distribution, recapitalization, merger, issuer tender or exchange offer, or other similar transaction, the Per Share Merger Consideration shall be equitably adjusted.

  • Fee Adjustments The fixed fees and other fees expressed as stated dollar amounts in this Schedule C and in this Agreement are subject to annual increases, commencing on the one-year anniversary date of the date of this Agreement, in an amount equal to the percentage increase in consumer prices for services as measured by the United States Consumer Price Index entitled “All Services Less Rent of Shelter,” or a similar index should such index no longer be published, since such one-year anniversary or since the date of the last fee increase, as applicable. SCHEDULE D SPECIAL DISTRIBUTION SERVICES AND FEES Services Fees

  • Share Adjustments If the Company's outstanding shares of Common Stock are increased or decreased or changed into or exchanged for a different number or kind of shares or other securities of the Company by reason of any recapitalization, reclassification, stock split, combination of shares, stock dividend, or transaction having similar effect, the Board shall proportionately and appropriately adjust the number and kind of shares that are subject to this Option and the Exercise Price Per Share, without any change in the aggregate price to be paid therefor upon exercise of this Option.

  • PLAN CHANGES If a reinsured policy is changed to another plan of insurance that is not currently reinsured under this Agreement as defined in Schedule A, then the reinsurance, with respect to the reinsured policy, under this Agreement will cease as of the effective date of the change. If a policy that is not reinsured under this Agreement is changed to a plan that is reinsured under this Agreement as defined in Schedule A and the insured has met THE COMPANY’s underwriting requirements for the plan change, then reinsurance will commence as of the policy date of the new plan.

  • Payment and Year-End Adjustment Amounts accrued pursuant to this Agreement shall be payable to the Adviser as of the last day of each month. If necessary, on or before the last day of the first month of each fiscal year, an adjustment payment shall be made by the appropriate party in order that the actual Fund Operating Expenses of a Fund for the prior fiscal year (including any reimbursement payments hereunder with respect to such fiscal year) do not exceed the Maximum Annual Operating Expense Limit.

  • Adjustment, etc Any adjustment, indulgence, forbearance or compromise that might be granted or given by any of the Lenders to Borrower or Guarantor or any Person liable on the Liabilities;

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