CMS recently released the 2022 Advance Notice Part 1, with a heavy emphasis on the shift from RAPS to EDS to calculate risk scores. Here’s what you should know.
As the DOJ continues its efforts to investigate the diagnosis capture and reporting practices of MAOs, MAO executives must proactively evaluate their own risk adjustment programs.
Plan should start to take steps now to determine the impact of the blend and model change in the 2021 Advance Notice to their risk scores and revenue, and mitigate potential adverse impacts of the risk adjustment changes.
The Office of Inspector General (OIG) report on the use of chart reviews in Medicare Advantage risk adjustment raises a number of concerns for Medicare Advantage Organizations (MAOs). How can plans mitigate risk from chart review submissions and stay compliant with CMS risk adjustment guidelines to ensure complete and accurate reimbursement?
Was your plan selected for this year’s Medicare Part C Contract-Level Risk Adjustment Data Validation…