MA Plans Blast Risk Adjustment Final Rule; Mum On Litigation

By Bridget Early / January 31, 2023 at 7:04 PM
Medicare Advantage plans are lambasting CMS’ final rule released Monday (Jan. 30) that allows the agency to extrapolate audit data and retroactively claw back overpayments, but they won’t say whether they plan to pursue litigation -- though some insurers indicated prior to the rule’s debut they’d sue if CMS did not finalize a so-called fee-for-service adjuster, and the insurer lobby AHIP called the rule “unlawful.” The rule as initially proposed in 2018 said CMS would extrapolate MA plans’ audit data...

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