Shortly following its announcement of sweeping changes to RADV audits, CMS shared industry guidance last week regarding upcoming deadlines for the submission of risk adjustment data corrections in advance of RADV sampling. While this type of notice is routine in advance of RADV audit sampling, it is unique as it covers five plan years (2020 through 2024). CMS instructs Medicare Advantage organizations (MAOs) to submit data corrections for PY 2020 through PY 2024 with deadlines ranging from June 16, 2025, through July 15, 2025. Based on these dates and CMS’s target of completing these audits by early 2026, we believe that MAOs can expect to receive audit notices on a rolling basis beginning in the mid to late summer.

CMS’s decision to alter the long-standing audit time frame results in MAO

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