0938-AU23 202004 Unified Agenda of Federal Regulatory and Deregulatory Actions 0938 Centers for Medicare & Medicaid Services CMS 0900 Department of Health and Human Services HHS Amendments to the HHS-Operated Risk Adjustment Data Validation Under the Patient Protection and Affordable Care Act's HHS-Operated Risk Adjustment Program (CMS-9913)

This rule would adopt certain technical changes to the risk adjustment data validation error estimation methodology for states where the Department of Health and Human Services (HHS) operates the risk adjustment program.  The Patient Protection and Affordable Care Act (PPACA) established a permanent risk adjustment program under which payments are made to health insurance issuers that attract higher-than-average risk populations funded by payments from health insurance issuers that attract lower-than-average risk populations.  To ensure the integrity of the HHS-operated risk adjustment program, CMS, on behalf of HHS, performs risk adjustment data validation, also known as HHS-RADV, to validate the accuracy of data submitted by issuers for the purposes of risk adjustment transfer calculations. 

]]> Other Significant First Time Published in The Unified Agenda Proposed Rule Stage No No Other 45 CFR 153 Pub. L. 111-148, secs. 1321 and 1343 No NPRM 06/00/2020 No None No No No Allison Yadsko Health Insurance Specialist 0938 Centers for Medicare & Medicaid Services CMS 410 786-1740 allison.yadsko@cms.hhs.gov Center for Consumer Information and Insurance Oversight, MS: WB-24-40, 7500 Security Boulevard, Baltimore MD 21244