Distributed Data Collection (DDC) for RA Including HCRP/EDGE Server FAQ
Guidance for FAQ regarding Edge Server Operations and Policy
Program Area: Distributed Data Collection (DDC) for RA Including HCRP/EDGE Server
Question: How will the Department of Health and Human Services (HHS)/Centers for Medicare & Medicaid Services (CMS) assign the correct risk adjustment allowable rating factor for subscribers and policy members when the enrollment start and end dates are not based on a calendar year (JAN to DEC)?
Answer: The risk adjustment software code will compute each policy member's age at enrollment start date for initial policy issuance (code '021028'), policy renewal (code '021041'), or date of addition to the policy (code '021EC'). The Center for Consumer Information and Insurance Oversight (CCIIO) will end date all enrollment periods at 12/31/20XX for each payment year or use the end date provided by the issuer if the enrollment end date occurs before the end of the calendar year.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: December 11, 2014
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