- (a) The OHCA makes a prospective monthly payment to the PACE organization of a capitation amount for each Medicaid participant.
(b) The payment amount represents:
- (1) is less than the amount that would otherwise have been paid under the State plan if the participants were not enrolled under the PACE program.
- (2) Takes into account the comparative frailty of PACE participant.
- (3) is a fixed amount regardless of changes in the participant's health status.
- (c) The PACE organization must accept the capitation payment amount as payment in full for Medicaid participants.
Added at 31 Ok Reg 1748, eff 9-12-14