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

Issue Date: December 10, 2018

Program Area: ACA Financial Appeals (ACA FA)

Question: Will the Centers for Medicare & Medicaid Services (CMS) require issuers to complete the Risk Adjustment (RA) and Reinsurance (RI) Request for Reconsideration Web Form?

Answer: Completing the Request for Reconsideration Web Form is optional. Issuers who do not need to request reconsideration do not need to participate in the appeals process.

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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.