The Centers for Medicare and Medicaid Services (CMS) issued a final rule on the use of extrapolation to determine overpayments in risk adjustment data validation (RADV) audits of Medicare Advantage ...

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On February 1, the Centers for Medicare & Medicaid Services (CMS) published the Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) Program Final Rule (Final Rule), which will take effect ...

We collaborate with the world's leading lawyers to deliver news tailored for you. Sign Up for any (or all) of our 25+ Newsletters. Some states have laws and ethical rules regarding solicitation and ...

LEWES, Del., Oct. 21, 2025 (GLOBE NEWSWIRE) -- Martlet.ai, a healthcare AI company spun out of John Snow Labs, today announced the launch of its Risk Adjustment Data Validation (RADV) Audit Readiness ...

Medicare Advantage (MA) plans could face tougher risk adjustment audits after the Biden administration finalized a highly anticipated regulation Monday. The Centers for Medicare & Medicaid Services ...

A new overhaul to Medicare Advantage (MA) risk adjustment audits will still leave billions on the table if the Biden administration doesn’t go further, a group of experts contend. Several experts ...

A federal judge has thrown out a Biden-era rule that would have clawed back billions of dollars in overpayments from Medicare Advantage insurers in a major win for the industry. On Thursday, Judge ...

LOUISVILLE, Ky., June 26, 2025 /PRNewswire/ -- RAAPID, the M12 (Microsoft Venture) backed risk adjustment technology company, successfully concluded its executive webinar "Don't Wait for the Notice: ...

Insurers have been pushing back against a Medicare Advance Notice on payment rates and a Risk Adjustment Data Validation (RADV) final rule they say will affect consumers and taxpayers. With an eye ...