Risk Adjustment (RA) FAQ
Guidance for FAQ regarding Risk Adjustment Operations and Risk Scores
Program Area: Risk Adjustment (RA)
Question: How are risk scores aggregated to the issuer level?
Answer: Risk scores are only aggregated to the plan level in a rating area and results in the Plan Liability Risk Score (PLRS). Please refer to the 2019 Final Payment Notice located here https://www.govinfo.gov/content/pkg/FR-2018-04-17/pdf/2018-07355.pdf or the 2014 Final Payment Notice located here https://www.govinfo.gov/content/pkg/FR-2014-12-30/pdf/2014-30243.pdf on the Government Publishing Office (GPO) website.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: January 22, 2019
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