Risk Adjustment (RA) FAQ
Guidance for FAQ regarding Risk Adjustment Operations and Policy
Program Area: Risk Adjustment (RA)
Question: What will be included in the Risk Adjustment (RA) calculation estimate?
Answer: The RA calculation estimate is comprised of the issuer's plan average and individual enrollee Plan Liability Risk Scores (PLRS). For additional information, the RA program area has published 2 computer-based training (CBTs) located here Risk Scores Part One (1) https://www.regtap.info/reg_librarye.php?i=2141&type=v and Risk Scores Part Two (2) https://www.regtap.info/reg_librarye.php?i=2751&type=v in the REGTAP library.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: January 22, 2019
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