CMS: Medicare and Medicaid Programs: Policy and Technical Changes to the Medicare Advantage, Medicare Prescription Drug Benefit, Program of All-Inclusive Care for the Elderly, etc.

Notice of final rule from the Centers for Medicare& Medicaid Services (CMS) announcing policies to improve program integrity and payment accuracy in the Medicare Advantage (MA) program. This final rule codifies that, as part of the MA Risk Adjustment Data Validation (RADV) program audit methodology, CMS will extrapolate RADV audit findings beginning with payment year (PY) 2018 and will not extrapolate RADV audit findings for PYs 2011 through 2017. A policy is also being finalized whereby CMS will not apply an adjustment factor in RADV audits. This final rule is effective April 3, 2023.

Source: Federal Register updates via the Rural Assistance Center - February 1, 2023 Category: Rural Health Source Type: news