Risk Adjustment Calculation Timeline Clause Samples

Risk Adjustment Calculation Timeline. ‌ For Contract Year 2021, the MCO’s aggregate risk scores will be calculated two times. 4.5.5.1 For Capitation Payments for January through June 2021, the MCO will receive aggregate risk scores calculated by the STATE, using:‌  Encounter claims and FFS claims for dates of service of July 2019 through June 2020 (the assessment period) that include a warrant date no later than October 13, 2020, and  The MCO’s enrollment as of October 2020 (the exposure month), for each population subject to risk adjustment. 4.5.5.2 For Capitation Payments for July through December 2021, the MCO will receive aggregate risk scores calculated by the STATE, using:‌  Encounter claims and FFS claims for dates of service of January 2020 through December 2020 (the assessment period) that include a warrant date no later than April 13, 2021 and  The MCO’s enrollment as of April 2021 (the exposure month), for each population subject to risk adjustment.
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Risk Adjustment Calculation Timeline. For Contract Year, the MCO’s aggregate risk score will be calculated two times.
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Risk Adjustment Calculation Timeline. ‌ For Contract Year 2022, the MCO’s aggregate risk scores will be calculated two times. 4.5.5.1 For Capitation Payments for January through June 2022, the MCO will receive aggregate risk scores calculated by the STATE, using: • Encounter claims and FFS claims for dates of service of January 2020 through June 2021 (the assessment period) that include a warrant date no later than October 12, 2021, and • The MCO’s enrollment as of October 2021 (the exposure month), for each population subject to risk adjustment. 4.5.5.2 Exception process for Contract Year 2022 for the Hennepin, ▇▇▇▇▇▇ and Metro rate setting regions. The STATE will apply an aggregate risk score of 1.0 to January 2022 through June 2022 Capitation Payments, until such time as the aggregate risk score is calculated as below to be applied to forthcoming capitation payments. The STATE will then process retrospective adjustments for January 2022 through June 2022 Capitation Payments as necessary using the risk scores calculated in section 4.5.5.3 below. 4.5.5.3 For Capitation Payments for July through December 2022, the MCO will receive aggregate risk scores calculated by the STATE, using: • Encounter claims and FFS claims for dates of service of July 2021 through December 2021 (the assessment period) that include a warrant date no later than April 12, 2022 and • The MCO’s enrollment as of April 2022 (the exposure month), for each population subject to risk adjustment.
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Related to Risk Adjustment Calculation Timeline

  • Payment Calculation District shall pay Contractor at a rate of $ per . District shall pay Contractor as described in attached Exhibit A

  • Price Adjustment Civil works contracts of long duration (more than 18 months) shall contain an appropriate price adjustment clause.

  • CPI Adjustment If the CPI Percentage Increase (as defined below) is more than [***] for the relevant Adjustment Period, then the Rent payable during that Adjustment Period shall be adjusted upward by a percentage equal to the CPI Percentage Increase (as defined below) applicable to such Adjustment Period, but not to exceed an adjustment during any Adjustment Period of greater than [***]. The term “Consumer Price Index” shall mean the unadjusted Consumer Price Index for All Urban Workers, U.S. City Average, All Items, 1982-84=100, calculated and published by the United States Department of Labor, Bureau of Labor Statistics. The “CPI Percentage Increase” shall mean, with respect to any Adjustment Period, [***]. For the avoidance of doubt, no CPI Adjustment shall be made to any payment due under this Ground Lease for any Adjustment Period if the result of such CPI Adjustment would be to (a) reduce the amount of such payment to an amount that is less than the amount of such payment due for the immediately preceding Adjustment Period or (b) to raise the amount of such payment to an amount that is greater than [***]. For illustrative purposes only, [***]. The CPI Percentage Increase for any Adjustment Period shall be calculated by the Tenant, and the Tenant shall deliver written notice to the Landlord describing such calculation in reasonable detail (a “CPI Notice”) no later than thirty (30) days after the commencement of any Adjustment Period. If the Landlord disagrees with the Tenant’s calculation of the CPI Percentage Increase, then the Landlord shall deliver to the Tenant written notice, describing the basis for such disagreement in reasonable detail (a “CPI Disagreement Notice”), not later than thirty (30) days after delivery of the CPI Notice. If the Landlord fails to deliver a CPI Disagreement Notice within thirty (30) days after delivery of any CPI Notice, then the Landlord shall be conclusively deemed to have agreed with the calculation of the CPI Percentage Increase set forth in such CPI Notice.

  • Year-End Adjustment 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 Operating Expense Limit.

  • Market Adjustment The parties to this Agreement recognize the appropriateness of market pay adjustments in rare instances for compelling reasons. To effectuate judgments in such cases, the President and AAUP Chapter President, in consultation, shall each name three (3) individuals to a university Market Evaluation Committee. Deans may submit recommendations for market pay adjustments with supporting written reasons to the committee. Said Committee shall consult with the President concerning proposed market pay adjustments reporting its advice not later than May 15 in each year. Upon the favorable recommendation of the President and the Chancellor, market pay adjustments may be approved effective at the beginning of that pay period including September 1 of the following year. Not more than one (1) market pay adjustment per one hundred (100) full-time members, or fraction thereof, may be recommended in any contract year. A member’s salary may not be increased beyond the maximum for the rank. Funding for this program shall be governed by Article 12.10.2.