Risk Corridor Settlement and Payments Clause Samples

Risk Corridor Settlement and Payments. 1. Department will complete a settlement determination for the Risk Corridor Measurement Period. This determination shall be made for the Medicaid Expansion Eligible Member population independent of the non-Medicaid Expansion population determination. 2. PIHP shall provide the Department with an interim Risk Corridor Services Ratio report on a timeline and in a format prescribed by Department. 3. PIHP shall provide the Department with a final Risk Corridor Services Ratio report on a timeline and in a format prescribed by the Department. 4. PIHP shall provide explanations for any allocation methods required to split expenditures between Medicaid Expansion Eligible Member and non-Medicaid Expansion populations. 5. PIHP shall provide additional information and documentation at the request of Department to support the Risk Corridor Settlement determination. 6. Department may choose to review or audit any information submitted by PIHP. 7. Department will complete a Risk Corridor Settlement determination for the Risk Corridor Measurement Period. In preparing the settlement, Department will make final decisions about covered costs included in the settlement. 8. Department will provide PIHP with written notification and corresponding documentation of the final Risk Corridor Settlement determination prior to initiating a payment or remittance. The risk corridor settlement shall become final if dispute resolution is not requested pursuant to Section V. Contract Performance within thirty (30) Calendar Days of the notice by Department to PIHP. 9. If the final Risk Corridor Settlement requires PIHP to remit funds to Department, the PIHP must submit any undisputed remittance to Department within ninety (90) Calendar Days of the date of Department’s notification of the final Risk Corridor settlement. If PIHP initiates a dispute as described in Section V. Contract Performance the deadline for PIHP to submit remittance to Department shall be stayed pending the outcome of the dispute. 10. At the sole discretion of Department, Department may allow PIHP to contribute all or a part of the amount otherwise to be remitted to: a. Contributions to health-related resources targeted towards high-impact initiatives that align with Department’s Quality Strategy that have been reviewed and approved by the Department. b. Contribute to initiatives that advance Health Equity in alignment with the Department’s Quality Strategy that have been reviewed and approved by Department. 11. To be c...
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Risk Corridor Settlement and Payments. The Department will complete a settlement determination for the Risk Corridor Measurement Period.
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Risk Corridor Settlement and Payments a) The Department will complete a settlement determination for each Risk Corridor Measurement Period. b) The PHP shall provide the Department with an interim Risk Corridor Services Ratio report on a timeline and in a format prescribed by the Department. c) The PHP shall provide the Department with a final Risk Corridor Services Ratio report on a timeline and in a format prescribed by the Department. The risk corridor settlement will consider the outcome of the Minimum Primary Care Expenditure requirement evaluation. As such, the final Risk Corridor settlement will include the following two iterations of the Risk Corridor Services Ratio report. 1. Preliminary Risk Corridor Services Ratio report will exclude from the numerator any payments required from the Minimum Primary Care Provider Expenditure requirement. 2. Final Risk Corridor Services Ratio report will consider the final outcome and any payments required from the Minimum Primary Care Provider Expenditure requirement for the applicable risk corridor measurement period. d) The PHP shall provide additional information and documentation at the request of the Department to support the Risk Corridor Settlement determination.
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Risk Corridor Settlement and Payments a) The Department will complete a settlement determination for the Risk Corridor Measurement Period. b) The PHP shall provide the Department with an interim Risk Corridor Services Ratio report on a timeline and in a format prescribed by the Department. c) The PHP shall provide the Department with a final Risk Corridor Services Ratio report on a timeline and in a format prescribed by the Department. The risk corridor settlement will consider the outcome of the Minimum Primary Care Expenditure requirement evaluation. As such, the final Risk Corridor settlement will include the following two iterations of the Risk Corridor Services Ratio report. 1. Preliminary Risk Corridor Services Ratio report will exclude from the numerator any payments required from the Minimum Primary Care Provider Expenditure requirement. 2. Final Risk Corridor Services Ratio report will consider the final outcome and any payments required from the Minimum Primary Care Provider Expenditure requirement. d) The PHP shall provide additional information and documentation at the request of the Department to support the Risk Corridor Settlement determination. e) The Department may choose to review or audit any information submitted by the PHP. f) The Department will complete a Risk Corridor Settlement determination for the Risk Corridor Measurement Period. In preparing the settlement, the Department will make final decisions about covered costs included in the settlement. g) The Department will provide the PHP with written notification and corresponding documentation of the final Risk Corridor Settlement determination prior to initiating a payment or remittance. The risk corridor settlement shall become final if dispute resolution is not requested pursuant to Section VI.A.e.vii. of the Contract within fifteen (15) Calendar Days of the notice by the Department to the PHP. h) If the final Risk Corridor Settlement requires the PHP to remit funds to the Department, the PHP must submit remittance to the Department within ninety
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Related to Risk Corridor Settlement and Payments

  • Settlement Funding and Payments 4.1 Payments from the Gross Settlement Amount. Five (5) business days prior to the anticipated Effective Date, the Administrator will send Class Counsel and Defendant’s Counsel the account information so that Defendant can wire the GSA. Within 10 business days after Defendant funds the Gross Settlement Amount, the Administrator will mail checks to the Participating Class Members, Aggrieved Employees, the LWDA, Class Counsel, and Class Representatives pursuant to the allocations set forth in Section 3 of this Agreement. Disbursement of the Class Counsel Fees Payment, the Class Counsel Litigation Expenses Payment and the Class Representative Service Payments shall not precede disbursement of Individual Class Payments and Individual PAGA Payments. 4.2 Uncashed Checks. Settlement checks that are not cashed within 160 calendar days from the date of issuance by the Administrator will be voided. The Administrator shall transmit the funds represented by such voided checks in conformity with the Code of Civil Procedure Section 384, subd. (b) to Bet Tzedek (“Cy Pres Recipient”).

  • Payment of Settlement Amount (1) Within thirty (30) days of the Date of Execution, the Settling Defendants shall pay the Settlement Amount to Siskinds LLP, for deposit into the Trust Account. (2) Payment of the Settlement Amount shall be made by wire transfer. At least thirty (30) days prior to the Settlement Amount becoming due, Siskinds LLP will provide, in writing, the following information necessary to complete the wire transfers: name of bank, address of bank, ABA number, SWIFT number, name of beneficiary, beneficiary’s bank account number, beneficiary’s address, and bank contact details. (3) The Settlement Amount and other consideration to be provided in accordance with the terms of this Settlement Agreement shall be provided in full satisfaction of the Released Claims against the Releasees. (4) The Settlement Amount shall be all-inclusive of all amounts, including, without limitation, interest, costs, Class Counsel Fees and Class Counsel Disbursements. (5) The Releasees shall have no obligation to pay any amount in addition to the Settlement Amount, for any reason, pursuant to or in furtherance of this Settlement Agreement, the Proceedings, the Second Ontario Action, or any Other Actions. (6) Once a Claims Administrator has been appointed, Siskinds LLP shall transfer control of the Trust Account to the Claims Administrator. (7) Siskinds LLP and the Claims Administrator shall maintain the Trust Account as provided for in this Settlement Agreement. (8) Siskinds LLP and the Claims Administrator shall not pay out all or any part of the monies in the Trust Account, except in accordance with this Settlement Agreement, or in accordance with an order of the Courts obtained after notice to the Parties.