Insurers have been pushing back against a Medicare Advance Notice on payment rates and a Risk Adjustment Data Validation (RADV) final rule they say will affect consumers and taxpayers. With an eye toward improving program integrity, the Risk Adjustment Data Validation (RADV) rule modifies how CMS calculates what a plan has to pay back to the federal government when risk
Centers for Medicare and Medicaid Services released the final rule on risk adjustment data validation audits of Medicare Advantage organizations. There are three key components of the Final Rule and requires MAOs to remit improper payments identified during RADV audits.
The Centers for Medicare & Medicaid Services (CMS) recently issued a Medicare-related final rule invoking the agency’s statutory authority to promulgate retroactive rules after finding.
Enrollment in Medicare Advantage plans increased by 5.5% this year, or by 1.5 million beneficiaries, according to The Chartis Group. But in 2020, 2021 and 2022, enrollment rose by 1.9 million, 2.2 million and 2.3 million, respectively.
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