Cal. Code Regs. Tit. 22, § 53320 - Capitation Payment

(a) Payment to each plan shall be on a monthly capitation payment basis. Each plan shall be at risk for services provided. The capitation payment shall:

(1) Constitute payment in full by the State for health care and administration services rendered under the contract.

(2) Be based upon a count of eligible members furnished to the plan monthly by the Department.

(b) The capitation payment shall not include payment for recoupment of any losses incurred by the plan under any prior contractual obligations with the State.

(c) Capitation payment shall not be made for members enrolled in excess of the enrollment maximums specified in the plan contract.

Notes

Cal. Code Regs. Tit. 22, § 53320

1. Editorial correction of NOTE filed 2-2-83 (Register 83, No. 6).

Note: Authority cited: Section 14312, Welfare and Institutions Code. Reference: Section 14301, Welfare and Institutions Code.

1. Editorial correction of NOTE filed 2-2-83 (Register 83, No. 6).