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

Issue Date: February 23, 2016

Program Area: CSR Reconciliation (CSR)

Question: The claims re-adjudication process does not seem to be an actuarial function. Why do issuers need an actuary to sign Attestation Forms A and B?

Answer: Many aspects of the claims re-adjudication process involve actuarial estimation or results. The issuer's actuary may delegate the signature to the chief executive officer or other senior company official as an authorized representative.

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