Reimbursement Methodologies Sample Clauses

Reimbursement Methodologies. 1. Interim payments Interim payments may be made to eligible providers as described below. For the period October 1, 2010 through December 31, 2010, an eligible provider’s interim payment will be a quarterly urgent sustainability payment equal to 25 percent of the provider’s average annual historical grant award received under PCASG amount as described in STC 23. For the period January 1, 2011 through September 30, 2011, an eligible provider’s interim payment will be monthly up to one third of the quarterly urgent sustainability payment. Interim payments may be reduced by DHH at the request of the provider and after consideration of limitations to ensure budget neutrality and promote sustainability. The amount of interim payments, including urgent sustainability payments, made to providers in the period of October 1, 2010 through September 30, 2011 will be reconciled against the actual payments that would have been made to the providers to reimburse waiver related costs through targeted payments, incentive payments, and encounter rate payments for dates of service during the period. The reconciliation shall occur simultaneously with the adjustment described in Section II. B. 1. for Demonstration Year 1. After supplemental payments calculated in Section II. B. 1., any overpayments may be offset against a provider’s payment in the quarter following the reconciliation. Any underpayments may be made in the quarter following the reconciliation, subject to any limitations necessary to maintain budget neutrality and promote sustainability. This reconciliation will be completed and a document detailing the reconciliations and any over or under payments identified will be submitted to CMS by December 31, 2011.