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Medicaid HMO 2005-2006 Capitation Rates
AHCA uses the methodology that was developed by Milliman and Robertson in FY
00/01 to:
- Establish an upper payment limit as an estimate of the cost of providing
care for the HMO population in a fee-for-service setting;
- Set capitation rates less than the upper payment limit;
- Develop rates acceptable to HCFA;
- Provide fair reimbursement to the HMOs;
- Foster an increase in rural HMO participation; and
- Minimize the impact of year-to-year fluctuation.
A Summary by Age, Eligibility
Category, and Area provides general information about the 2005-2006
Medicaid HMO Capitation Rates. More detailed information is available in the
appendices listed below, posted in zipped files for your convenience.
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Zip File
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| TANF/AFDC (Appendix
A) |
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| SSI - No Medicare
(Appendix B) |
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| SSI - Medicare
A & B (Appendix C) |
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| SSI - Medicare
B (Appendix D) |
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The following zip files document the changes effective January 1, 2006 for dual eligibles only:
Appendix C - Dual Eligibles
Appendix D - Dual Eligibles
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