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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.
On January 30, 2023, the Centers for Medicare & Medicaid Services released the long-delayed final rule on risk adjustment data validation audits of Medicare Advantage organizations
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
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.