We’re required by the Department of Health and Human Services (HHS) to validate the accuracy of risk adjustment data annually for members of Affordable Care Act plans.
If one or more of your patients is part of the HHS Risk Adjustment Data Validation (HHS-RADV) random sample, you may soon receive a request for medical records that will be used to validate 2017 data. You are required to participate in this federally mandated audit.
If you receive a request, we appreciate your immediate attention. Please send all medical records requested directly to us; do not forward any medical records to CMS or its contractors. If you have any questions about this audit, please contact the Risk Adjustment team at 617-246-3059.