Medicare Managed Care Manual (Pub. 100-16), Ch. 17c § 110
Allocation and Distribution of Other Administrative and General
110 - Allocation and Distribution of Other Administrative and General
Costs
(Rev. 4, 10-01-01)
Administrative and General (A&G) costs other than those described in section 100 of this
chapter which bear a significant relationship to the services rendered are not apportioned
to Medicare directly. Instead, these costs are allocated or distributed to the components
of the cost-based HMO/CMP which, in turn, are then apportioned to Medicare in
accordance with the rules contained in this chapter. The allocation or distribution process
occurs in two steps:
1. The total allowable costs of a separate entity or department that performs
administrative services (e.g., centralized purchasing, accounting, data processing)
that can be quantitatively measured, should be allocated or distributed to each
component of the HMO/CMP in reasonable proportion to the benefits received by
that component.
2. Those remaining service-related administrative costs that cannot otherwise be
distributed or allocated in reasonable proportion to the benefits received by the
components must be allocated to the components on the basis of a ratio of total
incurred and distributed cost of the component to total incurred and distributed
cost to all components.