Interim Per Capita Rate

10.3.2 - Interim Per Capita Rate (Rev. 4, 10-01-01) The interim per capita rate for a cost-based HMO/CMP is determined by dividing estimated reimbursable costs of providing Medicare-covered services to the HMO/CMP's Medicare enrollees by projected Medicare enrollee months for the contract period. Estimated reimbursable costs and the projected number of Medicare enrollee months are derived from the HMO/CMP's annual operating budget and enrollment forecast. The number of Medicare enrollees may be compared to CMS’s latest updated records of enrollment for reasonableness. These records will identify the number of Medicare beneficiaries CMS has identified as enrollees of the HMO/CMP.