JD Supra

CMS’s Final RADV Rule Announces No Extrapolation Methodology, No FFS Adjuster

The Centers for Medicare and Medicaid Services (CMS) issued a final rule on the use of extrapolation to determine overpayments in risk adjustment data validation (RADV) audits of Medicare Advantage ...
JD Supra

CMS Medicare Advantage RADV Final Rule: No Fee-For-Service Adjuster, May Extrapolate Audit Findings Beginning with PY 2018

CMS estimates that RADV audits will recover approximately $4.7 billion from MAOs between 2023 – 2032. CMS will specify how MAOs must remit improper payments identified as a result of a RADV audit to ...