RADV-IVA Benefit Year 2019
CMS issued the HHS Risk Adjustment Data Validation (HHS-RADV-IVA) timeline of activities for the Benefit Year 2019 on August 4, 2020. After a four month wait, we now know that CMS will be moving forward with a new timeline for BY 2019 kicking off January 2021.
IVA Entities will elect to participate starting on October 5, 2020. Issuers (Health Plans) will begin designating their IVA Entity on December 1, 2020. Per the timeline, we hope to see the new protocols shared/posted to Regtap in November. The final HHS-RADV sampling command is scheduled to run on January 19, 2021. The deadline for Package 1 submission closes on Wednesday, September 1, 2021 at 8:00pm EST. The deadline for Package 2 submission closes on Thursday, September 9, 2021 at 8:00pm EST along with the IVA Entity Inter-rater Reliability (IRR) submission.
CMS also included a sentence stating “CMS anticipates that 2020 benefit year HHS-RADV will commence as usual with the release of IVA samples in May 2021.”
Running two HHS-RADV audits, in the 2021 calendar year along with HEDIS and Medicare Advantage RADV will have the provider networks and organizations competing for resources. Proactive communication with the providers will be imperative to successful and timely medical record retrieval operations. We must all work together to encourage those in the provider offices and hospitals to understand the requirements behind these regulations.
For questions regarding the 2019 Benefit Year & 2020 Benefit Year HHS-RADV Activities Timeline, you may email Reveleer at PayerCommunity@reveleer.com
You may also contact CMS directly at CCIIOACARAdatavalidation@cms.hhs.gov
