CMS Makes Significant Updates to and Expands Scope of Medicare Advantage RADV Audits

The Centers for Medicare & Medicaid Services (CMS) announced a significant expansion of its primary auditing tool used for Medicare Advantage (MA) plans or contracts. CMS conducts Risk Adjustment Data Validation audits to help ensure the accuracy of payments based on the health status of Medicare beneficiaries in the MA program. In this article, Tyler Marshall provides a detailed summation of the CMS changes.