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Page 7 - Risk Adjustment Data Validation News Today : Breaking News, Live Updates & Top Stories | Vimarsana

The RADV Final Rule and Advance Notice of CY 2024 Capitation Rates: Provider Considerations | Nelson Mullins Riley & Scarborough LLP

The Centers for Medicare & Medicaid Services (CMS) was very busy last week! On Jan. 30, CMS issued its long-awaited Risk Adjustment Data Validation (RADV) Final Rule.

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Natural language processing creates an audit trail for risk adjustment

The best way for insurers to make sure they're in compliance with the mandates of risk adjustment is to use natural language processing for accurate documentation and auditing, according to Dr. Calum Yacoubian, director, Healthcare Strategy, Linguamatics, an IQVIA company that offers an NLP-based AI platform. Last week's publication of the final rule for risk adjustment data

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CMS Finalized Rule on Medicare Advantage RADV Audits

The Centers for Medicare and Medicaid Services finalized a rule on Medicare Advantage Risk Adjustment Data Validation audits eliminating the fee for service adjuster from CMS’s methodology for extrapolating audit findings but limits extrapolation to plan years 2018 and beyond.

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CMS Audit Methos for Medicare Advantage

Feb 1, 2023 Centers Medicare Medicaid Services published final rule outlining audit methodology for Medicare Advantage MA Risk Adjustment Data Validation RADV program, due to obligation of MAOs to return improper payments, recent case law UnitedHealthcare Insurance Co. v. Becerra

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CMS s Final Rule on Medicare Advantage Risk Adjustment Data Validation | Epstein Becker & Green

On February 1, 2023, the Centers for Medicare & Medicaid Services (CMS) published a final rule outlining its audit methodology and related policies for its Medicare Advantage (MA) Risk.

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