[Federal Register Volume 84, Number 44 (Wednesday, March 6, 2019)]
[Proposed Rules]
[Pages 8069-8070]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-04052]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Part 422

[CMS-4185-N2]


Medicare Program; Release of Data Underlying Risk Adjustment Data 
Validation Provisions

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Proposed rule; supplement.

-----------------------------------------------------------------------

SUMMARY: This document announces the release of data underlying the 
proposed policies regarding the use of extrapolation in Medicare 
Advantage (MA) Risk Adjustment Data Validation (RADV) audits and the 
Fee-for-Service (FFS) Adjuster.

[[Page 8070]]


DATES: The data announced in this supplement is available on March 1, 
2019.

ADDRESSES: The LDS DUA request forms and instructions are available via 
the CMS website at https://www.cms.gov/Research-Statistics-Data-and-Systems/Files-for-Order/LimitedDataSets/. Additional documentation and 
data related to the RADV FFS Adjuster Study is posted on the Private 
Plans Team website at https://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-Risk-Adjustment-Data-Validation-Program/Resources.html.

FOR FURTHER INFORMATION CONTACT: Jonathan Smith, (410) 786-4671 or 
Joanne Davis, (410) 786-5127.

SUPPLEMENTARY INFORMATION:

I. Background

    In the November 1, 2018 Federal Register (83 FR 54982), we 
published a proposed rule titled ``Medicare and Medicaid Programs; 
Policy and Technical Changes to the Medicare Advantage (MA), Medicare 
Prescription Drug Benefit, Program of All-Inclusive Care for the 
Elderly (PACE), Medicaid Fee-For-Service, and Medicaid Managed Care 
Programs for Years 2020 and 2021''. The proposed rule included preamble 
language and regulatory provisions regarding the proposed MA Risk 
Adjustment Data Validation (RADV) audit methodology, and the proposal 
not to apply a Fee-For-Service (FFS) Adjuster (83 FR 55037 through 
55041 and 55077). Prior to the release of the proposed rule, we posted 
a FFS Adjuster Study on October 26, 2018.
    In the December 27, 2018 Federal Register (83 FR 66661), we 
published a document stating that we planned on releasing data 
underlying the FFS Adjuster Study and extending the comment period for 
the RADV provisions to April 30, 2019, in order to maximize the 
opportunity for the public to provide meaningful input to CMS.

II. Provisions of the Supplement

    This document announces that data, underlying our proposal not to 
apply a RADV FFS Adjuster, is available to the public through the 
Office of Enterprise Data Analytics (OEDA). Persons or entities 
requesting the data must complete and submit a Limited Data Set (LDS) 
Data Use Agreement (DUA) along with the required fee to CMS. The LDS 
DUA request forms and instructions are available via the CMS website at 
https://www.cms.gov/Research-Statistics-Data-and-Systems/Files-for-Order/LimitedDataSets/. Lastly, additional documentation and data 
related to the RADV FFS Adjuster Study is posted on the Private Plans 
Team website at https://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-Risk-Adjustment-Data-Validation-Program/Resources.html.
    We are releasing these data so the public can both provide 
meaningful comments regarding the proposed RADV provisions in the 
November 2018 proposed rule (83 FR 55037 through 55041 and 55077) and 
generate information that will be useful to the agency's decision 
makers. Our ability to meaningfully evaluate and respond to comments 
may depend on the extent to which commenters disclose any 
methodologies, statistical analyses, audit findings, and other factors 
underlying the comments.

III. Collection of Information Requirements

    This document does not impose information collection requirements, 
that is, reporting, recordkeeping or third-party disclosure 
requirements. Consequently, there is no need for review by the Office 
of Management and Budget under the authority of the Paperwork Reduction 
Act of 1995 (44 U.S.C. 3501 et seq.).

    Dated: February 28, 2019.
Seema Verma,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2019-04052 Filed 3-4-19; 11:15 am]
 BILLING CODE 4120-01-P