RADV Rule Sets MA Overpayment Recoup Strategy, Nixes FFS Adjuster

By Bridget Early / January 30, 2023 at 6:31 PM
CMS on Monday (Jan. 30) announced it will extrapolate Medicare Advantage audit data beginning with payment year 2018 as it moves to claw back overpayments with its long-awaited Medicare Advantage Risk Adjustment Data Validation (RADV) rule . Dara Corrigan, director of the Center for Program Integrity, said the agency anticipates retroactively recouping $479 million in overpayments from payment year 2018, and forecasts recovering around $4.7 billion between 2023 and 2032 based on the new audit structure. The department will not...

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