09/25/2020 | News release | Distributed by Public on 09/25/2020 13:08
On September 18, 2020, the Department of Health and Human Services Centers for Medicare & Medicaid Services issued the following message in a memo:
'This memo is to notify Medicare Advantage Organizations, PACE Organizations, Medicare-Medicaid Plans, Section 1833 Cost Contractors and Section 1876 Cost Contractors, and Demonstrations of upcoming deadlines to submit risk adjustment data for use in calculating risk scores for Payment Years (PY) 2020, 2021, and 2022. CMS will be adding an additional reconciliation run for PY2020. All risk adjustment data (Risk Adjustment Processing System (RAPS) Data and Encounter Data System (EDS) Data) that will be included in the listed risk score runs need to be submitted by 8pm ET of the 'Deadline for Submission.'
|Risk Score Run||Dates of Service||Deadline for Submission of Risk Adjustment|
|2020 Interim Final Run||01/01/2019 - 12/31/2019||Monday, 02/01/2021|
|2021 Mid-Year||01/01/2020 - 12/31/2020||Friday, 03/05/2021|
|2020 Final Run||01/01/2019 - 12/31/2019||Monday, 08/02/2021|
|2022 Initial||07/01/2020 - 06/30/2021||Friday, 09/03/2021|
While the 2020 Interim Final Run deadline remains Feb. 01, 2021; this memo officially sets the 2020 Final Run deadline to Aug 02, 2021, allowing Medicare Advantage Organizations six additional months to ensure a complete and accurate data submission. Final Run deadlines have been extended before (in 2017, due to Hurricane Harvey), but not to this level of advance notice and duration. This creates a unique opportunity for health plans to complete secondary reviews of your previously coded charts from 2019 dates of service, perform an additional analytics run to identify unclosed HCC gaps, and launch a supplemental chart chase where low friction retrieval methods are available.
Step-by-step Timeline for Optimizing Your Additional PY2020 Reconciliation Run (2019 Dates of Service):
Ciox is ready to help MAOs optimize the opportunity afforded by the additional reconciliation run through:
As you catch your second wind, consider secondary reviews and low friction supplemental chases to meet budget for PY2020. Learn more or get started at www.cioxhealth.com/crosscheck