Medicare Advantage RADV Final Rule: Implications for Industry
- February 24, 2023
- James Huang , Hogan Lovells US LLP
- Jessica Robinson Hanna , Hogan Lovells US LLP
On January 30, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a new Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) Final Rule.[1] The Final Rule codifies new CMS policies for RADV audits—including policies related to extrapolation of audit results and use of a “fee-for-service (FFS) adjuster” as part of RADV audits. The finalized policies are scheduled to take effect on April 3, 2023.
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