Fierce Healthcare January 6, 2020
CMS is planning to increase the amount of encounter data it uses to calculate Medicare Advantage risk scores to 75% from 50%, the agency said Monday.
The Centers for Medicare & Medicaid Services issued the first part of its 2021 MA Advance Notice — which focuses on risk adjustment — with the policies to be finalized no later than April 6 in the agency’s annual rate notice.
CMS previously increased the amount of encounter data it uses in such calculations to 50% for the 2020 plan year. It was a move that drew ire from the insurance industry, so Monday’s notice is also likely to draw scrutiny.
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