This excerpt taken from the MOH 10-Q filed May 10, 2006.
DUAL ELIGIBLES MEDI-CAL AND MEDICARE (Part D)
B. If DHS creates a new aid code that is split or derived from an existing aid code covered under this Contract, and the aid code has a neutral revenue effect for the Contractor, then the split aid code will automatically be included in the same aid code rate group as the original aid code covered under this Contract. Contractor agrees to continue providing Covered Services to the Members at the monthly capitation rate specified for the original aid code. DHS shall confirm all aid code splits, and the rates of payment for such new aid codes, in writing to Contractor as soon as practical after such aid code splits occur.
to Title 42, Code of Federal Regulations, Section 438.6(c)(2)(ii), the
actuarial basis for the computation of the capitation payment rates shall be
set forth in DHS most recent version of the annually-published Rate Manual for
the rate period that is identified in the Capitation Rate Sheets attached
hereto in Exhibit B, Attachment 1 (consisting of