CMS Releases Additional Data Related to Risk Adjustment Data Validation Proposed Rule

The Centers for Medicare and Medicaid Services (CMS) released additional materials, including study data, related to a previous proposed rule regarding Risk Adjustment Data Validation (RADV) audits.  In November 2019, CMS proposed a rule that would include significant changes to its RADV audit methodology.  Notably, the RADV proposal could result in the recovery of $4.5 billion Medicare Advantage plans over a 10 year period.  This week, the agency released additional documents intended to provide additional information for stakeholders developing their comments on this issue.

Comments on the proposed rule are due on August 28, 2019.


For more information visit the McDermottPlus Payment Innovation Resource Center or contact Mara McDermott at 202-204-1462 or