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

Issue Date: July 25, 2019

Program Area: Risk Adjustment (RA)

Question: How do I access my Health and Human Services Risk Adjustment Data Validation (HHS-RADV) Adjustment Issuer Reports issued on August 1, 2019?

Answer: The RADV Adjustment Issuer Report will be available on the EDGE Management Console. The report will be in comma-separated values (csv) format, zipped and contain two tabs - one tab for HHS-RADV adjustments to 2017 benefit year (BY) risk adjustment (RA) transfers and one tab for HHS-RADV adjustments to 2018 BY RA transfers. Please note there may not be adjustments for both benefit years. For example, if you were an issuer in a state market risk pool with an issuer that exited the market in BY 2018 with a 2017 HHS-RADV error rate, you will see an adjustment to your 2017 BY RA transfer amount. However, if no issuers exited your same state market risk pool, you will not see a 2017 BY HHS-RADV adjustment to your 2017 RA transfer amount. To view your report, please follow the steps below: 1. Login as Issuer Approver and Navigate to the RA/RI Payment & Charge Reports menu screen. 2. Look for Report Type: "IPIR - RI Proration" 3. Look for filename that looks like RADVADJ.HIOS-ID.DYYYYMMDDTHHMMSS.P.zip.csv 4. Click on the link to download the file. 5. Rename the file to remove the .csv extension (RADVADJ.HIOS-ID.DYYYYMMDDTHHMMSS.P.zip) 6. Extract the zip file to view the reports CMS is using the "IPIR-RI Proration" report type for the RADV Adjustment Issuer Report since that report type was no longer needed for reinsurance proration.

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