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2019 HHS Risk Adjustment Data Validation (HHS-RADV) White Paper

Guidance for The purpose of white paper is to outline potential options to modify the HHS risk adjustment data validation methodology for enrollee sampling, amend the current process that determines whether an issuer is an outlier, alter the error rate calculation that determines outlier issuers’ risk score adjustments, and change the
benefit year application of HHS-RADV results.

Download the Guidance Document

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: December 06, 2019

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.