Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: May 25, 2016

Program Area: ACA Financial Appeals (ACA FA)

Question: When completing the 'Discrepancy-Specific Information' reporting form, should issuers who have identified overlapping claims indicate either the Reinsurance Summary Report (RISR) or Risk Adjustment Transfer Elements Extract (RATEE) report, but not both?

Answer: Issuers should indicate whichever report is impacted by the overlapping claims discrepancy. At this time, the Centers for Medicare & Medicaid Services (CMS) does not anticipate the impact on Risk Adjustment (RA) to be significant.

HHS is committed to making its websites and documents accessible to the widest possible audience, including individuals with disabilities. We are in the process of retroactively making some documents accessible. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov.

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.