Risk Adjustment (RA) FAQ
Guidance for FAQ regarding Risk Adjustment Operations and Policy
Program Area: Risk Adjustment (RA)
Question: How and when do issuers pay Risk Adjustment (RA) user fees?
Answer: The Department of Health and Human Services (HHS) will collect RA user fees only once following the benefit year. - Per the HHS Notice of Benefit and Payment Parameters for 2017, RA user fees were assessed at $0.13 per-enrollee-per-month for the 2017 Benefit Year. - Per the HHS Notice of Benefit and Payment Parameters for 2018, RA user fees will be assessed at $0.14 per-enrollee-per-month for the 2018 Benefit Year. - Per the HHS Notice of Benefit and Payment Parameters for 2019, RA user fees will be assessed at $0.15 per-enrollee-per-month for the 2019 Benefit Year. For details on the user fee amount for each Benefit Year, please refer to the HHS Notice of Benefit and Payment Parameters for the applicable Benefit Year, located on the Centers for Consumer Information and Insurance Oversight (CCIIO) website at https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/index.html.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: September 17, 2018
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