California
§ 56322. Capitation Rate Redetermination.
1 provisions · California regulatory authority
Provisions
Citable source units
22 CCR 56322Reimbursement PaymentValue Based Arrangements
Capitation Rate Redetermination.
Allows midyear PCCM capitation-rate redetermination after specified legal or contractual changes produce a qualifying actuarial cost difference and requires approval and retroactive adjustment.
Group
Payment Program Integrity
Category
Reimbursement Payment
Domain
Billing Reimbursement
Topics
Capitation rate redetermination, Midyear payment adjustment, Actuarial cost threshold