36-2941. Establishment of capitation rates

A. The administration shall establish capitation rates based on an actuarial study for the department. The capitation rate shall be based on the estimated cost of providing services pursuant to this article to members who have been determined eligible pursuant to section 36-2933.

B. At least thirty days before finalizing the capitation rates, the administration shall send written notice of the proposed capitation rates to the department.

C. Capitation rate adjustments shall be limited to utilization of existing services and inflation unless policy changes, including creation or expansion of programs, have been approved by the legislature or are specifically required by federal law or court mandate.

36-2941. Establishment of capitation rates

A. The administration shall establish capitation rates based on an actuarial study for the department. The capitation rate shall be based on the estimated cost of providing services pursuant to this article to members who have been determined eligible pursuant to section 36-2933.

B. At least thirty days before finalizing the capitation rates, the administration shall send written notice of the proposed capitation rates to the department.

C. Capitation rate adjustments shall be limited to utilization of existing services and inflation unless policy changes, including creation or expansion of programs, have been approved by the legislature or are specifically required by federal law or court mandate.