Medicare and Medicaid Programs; Risk Adjustment Data Validation, 18215-18216 [2019-08691]

Agencies

• Centers for Medicare & Medicaid Services
• DEPARTMENT OF HEALTH AND HUMAN SERVICES

[Federal Register Volume 84, Number 83 (Tuesday, April 30, 2019)]
[Proposed Rules]
[Pages 18215-18216]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-08691]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Part 422

[CMS-4185-N3]
RIN 0938-AT59


Medicare and Medicaid Programs; Risk Adjustment Data Validation

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

ACTION: Proposed rule; extension of comment period and the announcement 
of the release of additional data.

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SUMMARY: This document extends the comment period for the Risk 
Adjustment Data Validation (RADV) provisions of the proposed rule 
titled ``Medicare and Medicaid Programs; Policy and Technical Changes 
to the Medicare Advantage, Medicare Prescription Drug Benefit, Program 
of All-inclusive Care for the Elderly (PACE), Medicaid Fee-For-Service, 
and Medicaid Managed Care Programs for

[[Page 18216]]

Years 2020 and 2021'' that was published in the November 1, 2018 
Federal Register. The comment period for the RADV provision of this 
proposed rule, which would end on April 30, 2019, is extended by 120 
days until August 28, 2019. This document also announces that CMS will 
be releasing additional data underlying the FFS Adjuster Study released 
October 26, 2018.

DATES: The comment period for RADV provisions (that is, section II.C.2. 
of the November 1, 2018 proposed rule and proposed Sec. Sec.  422.300, 
422.310(e) and 422.311(a) of the regulations text), published on 
November 1, 2018 (83 FR 54982), and extended on December 27, 2018 (83 
FR 66661), is further extended to 5 p.m. on August 28, 2019.

ADDRESSES: In commenting, please refer to file code CMS-4185-P. Because 
of staff and resource limitations, we cannot accept comments by 
facsimile (FAX) transmission.
    Comments, including mass comment submissions, must be submitted in 
one of the following three ways (please choose only one of the ways 
listed):
    1. Electronically. You may submit electronic comments on this 
regulation to https://www.regulations.gov. Follow the ``Submit a 
comment'' instructions.
    2. By regular mail. You may mail written comments to the following 
address ONLY: Centers for Medicare & Medicaid Services, Department of 
Health and Human Services, Attention: CMS-4185-P, P.O. Box 8013, 
Baltimore, MD 21244-8013.
    Please allow sufficient time for mailed comments to be received 
before the close of the comment period.
    3. By express or overnight mail. You may send written comments to 
the following address ONLY: Centers for Medicare & Medicaid Services, 
Department of Health and Human Services, Attention: CMS-4185-P, Mail 
Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850.
    For information on viewing public comments, see the beginning of 
the SUPPLEMENTARY INFORMATION section.

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

SUPPLEMENTARY INFORMATION: 
    Inspection of Public Comments: All comments received before the 
close of the comment period are available for viewing by the public, 
including any personally identifiable or confidential business 
information that is included in a comment. We post all comments 
received before the close of the comment period on the following 
website as soon as possible after they have been received: https://www.regulations.gov. Follow the search instructions on that website to 
view public comments.

Extension of the Public Comment Period

    In the November 1, 2018 proposed rule (83 FR 54982) titled, 
``Medicare and Medicaid Programs; Policy and Technical Changes to the 
Medicare Advantage, 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,'' we included 
preamble language and regulatory provisions regarding the proposed Risk 
Adjustment Data Validation audit methodology and the proposal not to 
apply a Fee-For-Service (FFS) Adjuster. We posted a FFS Adjuster Study 
on October 26, 2018.
    In the March 6, 2019 Federal Register (84 FR 8069), we published a 
document titled ``Medicare Program; Release of Data Underlying Risk 
Adjustment Data Validation Provisions'' that announced the release of 
data underlying the proposed policies regarding the use of 
extrapolation in MA Risk Adjustment Data Validation (RADV) audits and 
the Fee-for-Service (FFS) Adjuster.
    CMS is announcing the release of additional data underlying the 
October 26, 2018 FFS Adjuster Study. Updates to existing documentation 
related to the study data, as well as additional data without 
Personally Identifiable Information, were posted on the CPI Private 
Plans Team website on April 25, 2019. Additional data containing 
Protected Health Information are being made available by CMS to all 
parties who have entered into an applicable data use agreement and to 
those parties who can request this information if they agree to enter 
into an applicable data use agreement. CMS expects to release that data 
by June 14th. This will be the final release of data from the October 
26, 2018 FFS Adjuster Study.
    In addition to releasing this additional data from the previously 
published study, CMS intends to replicate that study, publish the 
results, and release associated data. Doing so will allow CMS to both 
test its initial results and release a more complete set of underlying 
data. Certain intermediate data elements not saved in the 
implementation of the initial study would be preserved in the 
replication and made available through publication.
    In order to maximize the opportunity for the public to provide 
meaningful input to CMS, we believe it is important to allow additional 
time for the public to prepare comments on the RADV provisions of the 
proposed rule. In addition, we believe granting a 120-day extension to 
the public comment period in this instance would further our overall 
objective to obtain public input and to generate information that will 
be useful to our agency's decision makers. Therefore, this document 
announces the extension of the public comment period until August 28, 
2019 for the RADV provisions included in the November 1, 2018 proposed 
rule (83 FR 55037 through 55041 and 55077).

    Dated: April, 22, 2019.
Seema Verma,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2019-08691 Filed 4-25-19; 4:15 pm]
 BILLING CODE 4120-01-P