Amendments to the HHS-Operated Risk Adjustment Data Validation (HHS-RADV) Under the Patient Protection and Affordable Care Act's HHS-Operated Risk Adjustment Program
other · Centers for Medicare and Medicaid Services · Rule · Published 2020-12-01 · Effective 2020-12-31 · 85 FR 76979
Document
Document number
2020-26338
Federal Register citation
85 FR 76979
CFR reference
45 CFR 153
Type
Rule
Action
Final rule.
Category
other
Sub-agency
Centers for Medicare and Medicaid Services
Publication date
2020-12-01
Effective date
2020-12-31
HHS docket
CMS-9913-F
Abstract
This final rule adopts certain changes to the risk adjustment data validation error estimation methodology beginning with the 2019 benefit year for states where the Department of Health and Human Services (HHS) operates the risk adjustment program. This rule is finalizing changes to the HHS-RADV error estimation methodology, which is used to calculate adjusted risk scores and risk adjustment transfers, beginning with the 2019 benefit year of HHS-RADV. This rule also finalizes a change to the benefit year to which HHS-RADV adjustments to risk scores and risk adjustment transfers would be applied beginning with the 2020 benefit year of HHS-RADV. These policies seek to further the integrity of HHS-RADV, address stakeholder feedback, promote fairness, and improve the predictability of HHS-RADV adjustments.