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

Issue Date: January 22, 2019

Program Area: Risk Adjustment (RA)

Question: Will the Centers for Medicare & Medicaid Services (CMS) provide issuers with specific diagnosis codes for issuers to use for risk adjustment?

Answer: CMS published an updated Do-it-Yourself (DIY) Risk Adjustment (RA) Risk Scores Model Algorithm software for Issuers to access each benefit year and additional updates are provided as needed during the calendar year. This document is on the CMS website at http://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/index.html.

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