California
§ 56321. Capitation Payment Rates Determination.
1 provisions · California regulatory authority
Provisions
Citable source units
22 CCR 56321Reimbursement PaymentValue Based Arrangements
Capitation Payment Rates Determination.
Requires annual actuarial determination of PCCM capitation rates, limits rates by Medi-Cal fee-for-service costs, and provides for interim and retroactive adjustments.
Group
Payment Program Integrity
Category
Reimbursement Payment
Domain
Billing Reimbursement
Topics
PCCM capitation rates, Actuarial payment determination, Medi Cal payment adjustments