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Cms Proposes Rule For 2018 Risk Adjustment Payments - Latest News


The 2020 Proposed Payment Notice, Part 2: Risk Adjustment

CMS is accepting comments on the proposed rule through February 19 ... Similar to the 2019 payment rule (and the more recent 2017 and 2018 risk adjustment methodology rules noted above), the preamble ... read more

CMS Proposes Rule for 2018 Risk Adjustment Payments

WASHINGTON -- The Centers for Medicare & Medicaid Services (CMS) continued its push to reinstate risk adjustment payments to health insurance plans, releasing a proposed rule to issue risk adjustment ... read more

CMS Proposes Risk-Adjustments Fix for 2018

"This rule does not propose to make any changes to the previously published HHS-operated risk adjustment methodology for the 2018 benefit year," the proposed ... CMS made last month in its rule for ... read more

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CMS finalizes risk adjustment rule for benefit year 2018

The Centers for Medicare & Medicaid Services (CMS) finalized its risk adjustment rule for the 2018 benefit year on Friday, its latest step in a string of legal battles dating back to earlier this year ... read more


CMS reinstates ACA risk-adjustment payments

The agency also said it will issue a notice of proposed rulemaking to seek feedback on the risk adjustment methodology for the 2018 benefit year. CMS Administrator Seema Verma said in a press release ... read more

CMS Issues Final Rule On 2018 Risk Adjustment Methodology; Litigation Likely To Continue

CMS is also likely to address additional changes to the risk adjustment program in the forthcoming notice of benefit and payment parameters ... to that laid out in the final rule for the 2017 ... read more

CMS proposes tweaks to 2019 Medicare Advantage risk-adjustment model

In 2019, the CMS said payment would be determined based on 75% of the old risk adjustment model used for payment in 2017 and 2018, and 25% of the proposed new risk adjustment model. By 2022, the new ... read more

Risk-Adjustment Fix Finalized for 2018 After Bout of Uncertainty

The freeze lasted only two-and-a-half weeks until CMS announced a final rule to resume the payments ... A similar fix for the 2018 benefit year was proposed two weeks later. Risk-adjustment payment ... read more

Risk adjustment payments to be based on 2018 premiums, CMS proposes

CMS will use the statewide average premium for the 2018 benefit year in its risk adjustment payment calculations ... funds to insurers with more high-cost members. Prior to the proposed rule, CMS ... read more

CMS proposed rule expands telehealth for Medicare Advantage plans, beefs up payment audits

The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule ... for risk adjustment calculation. The agency proposed using extrapolation for Risk Adjustment Data Validation audits, ... read more

CMS finalizes plan to continue risk-adjustment program for 2018

The CMS ... payments to insurers for 2017 under the risk-adjustment program, but later that month issued a final rule restoring the program for that year. The rule released Friday allows CMS to move ... read more

CMS proposes Medicare Advantage risk adjustment increase

... with a blend of 75% of the risk adjustment model used for payment in 2017 and 2018 and 25% of the new risk adjustment model proposed." Ana Gupte of Leerink Partners suggests the CMS' proposal is ... read more



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