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 California Code of Regulations (Last Updated: August 6, 2014)
 Title 22. Social Security
 Division 3. Health Care Services
 Subdivision 1. California Medical Assistance Program
 Chapter 6. Primary Care Case Management Plans
 Article 3. Operational Requirements

  § 56320. Capitation Payment.  

Latest version.
  • (a) Payment to each PCCM plan shall be on a monthly capitation payment basis. Each PCCM plan shall be at risk for capitated services provided under the PCCM contract. The capitation payment shall:
    (1) Constitute payment in full by the Department for health care and administrative services rendered under the PCCM contract.
    (2) Be based upon a count of eligible members furnished to the PCCM plan monthly by the Department.
    (b) The capitation payment shall not include payment for recoupment of any losses incurred by the PCCM plan under any prior contractual obligations with the State.
HISTORY
1. New section filed 3-9-90 as an emergency; operative 3-9-90 (Register 90, No. 12). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 7-9-90.
2. New section refiled 7-9-90 as an emergency; operative 7-9-90 (Register 90, No. 35). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed by operation of law on 11-6-90.
3. Request to readopt section on an emergency basis pursuant to Government Code section 11346.1 granted and filed 11-6-90 as an emergency; operative 11-6-90 (Register 91, No. 6). A Certificate of Compliance must be transmitted to OAL by 3-6-91 or emergency language will be repealed by operation of law on the following day.
4. Certificate of Compliance as to 11-6-90 order transmitted to OAL 2-22-91; disapproved by OAL on 3-25-91 (Register 91, No. 18).
5. New section filed 3-25-91 as an emergency; operative 3-25-91 (Register 91, No. 18). A Certificate of Compliance must be transmitted to OAL by 7-23-91 or emergency language will be repealed by operation of law on the following day.
6. Certificate of Compliance as to 3-25-91 order including repealer of subsection (c) transmitted to OAL 7-19-91 and filed 8-19-91 (Register 92, No. 1).

Note

Note: Authority cited: Sections 14105 and 14124.5, Welfare and Institutions Code. Reference: Section 14088.16, Welfare and Institutions Code.