The new era of RADV: What plans must do now

As the RADV audit landscape evolves, health plans face the dual challenge of adapting to new CMS requirements while maintaining the core activities that drive their revenue. This session addresses how organizations can act with urgency, balance competing demands, and strategically invest in resources to ensure audit readiness—without compromising other critical risk adjustment operations.  

Discussion topics:

• RADV fundamentals and current audit landscape: Gain clarity on the basics of Risk Adjustment Data Validation (RADV), why it matters, and how the audit environment is evolving.
• CMS policy updates and what’s new in 2025: Review the most recent changes from the Centers for Medicare & Medicaid Services (CMS), including new extrapolation rules, audit methodologies, and compliance expectations.
• Strategies for effective RADV audit response: Learn best practices for preparing your organization, responding to audit requests, and minimizing financial and compliance risks.