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HHS/CMS | RIN: 0938-AU23 | Publication ID: Fall 2020 |
Title: 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) | |
Abstract:
This rule adopts certain changes to the risk adjustment data validation error estimation methodology starting with the 2019 benefit year and beyond 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 HHSRADV, to validate the accuracy of data submitted by issuers for the purposes of risk adjustment transfer calculations. |
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Agency: Department of Health and Human Services(HHS) | Priority: Other Significant |
RIN Status: Previously published in the Unified Agenda | Agenda Stage of Rulemaking: Completed Actions |
Major: No | Unfunded Mandates: No |
EO 13771 Designation: Other | |
CFR Citation: 45 CFR 153 | |
Legal Authority: Pub. L. 111-148, secs. 1321 and 1343 |
Legal Deadline:
None |
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Timetable:
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Regulatory Flexibility Analysis Required: No | Government Levels Affected: None |
Federalism: No | |
Included in the Regulatory Plan: No | |
RIN Data Printed in the FR: No | |
Agency Contact: Allison Yadsko Health Insurance Specialist Department of Health and Human Services Centers for Medicare & Medicaid Services Center for Consumer Information and Insurance Oversight, MS: WB-24-40, 7500 Security Boulevard, Baltimore, MD 21244 Phone:410 786-1740 Email: allison.yadsko@cms.hhs.gov |