Calculation of Gains and Losses. The risk-sharing arrangement described in this section of the Contract may result in payment by EOHHS and CMS to the Contractor or by the Contractor to EOHHS and CMS. a. All payments to be made by EOHHS and CMS to the Contractor or by the Contractor to EOHHS and CMS will be calculated and determined jointly by EOHHS and CMS. b. All calculations, determined jointly by EOHHS and CMS, will be based on the Contractor’s reporting of Actual and Adjusted Service and Non-Service Expenditures, as required in Section 4.6.B.4 below. All financial reporting will be subject to review and/or audit at EOHHS’ and CMS’ discretion. c. CMS and EOHHS will perform an interim settlement and a final settlement of the payments made by the Contractor to CMS and EOHHS, or by CMS and EOHHS to the Contractor, as described in Section 4.6.B.4 below.
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Sources: Three Way Contract for Capitated Model, Three Way Contract for Capitated Model
Calculation of Gains and Losses. The risk-sharing arrangement described in this section of the Contract may result in payment by EOHHS and CMS to the Contractor or by the Contractor to EOHHS and CMS.
a. All payments to be made by EOHHS and CMS to the Contractor or by the Contractor to EOHHS and CMS will be calculated and determined jointly by EOHHS and CMS.
b. All calculations, determined jointly by EOHHS and CMS, will be based on the Contractor’s reporting of Actual and Adjusted Service and Non-Service Expenditures, as required in Section 4.6.B.4 below. All financial reporting will be subject to review and/or audit at EOHHS’ and CMS’ discretion.
c. CMS and EOHHS will perform an interim settlement and a final settlement settlements of the payments made by the Contractor to CMS and EOHHS, or by CMS and EOHHS to the Contractor, as described in Section 4.6.B.4 below.
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