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

Issue Date: May 22, 2020

Program Area: Risk Adjustment (RA)

Question: How do I access my Risk Adjustment (RA) payment reports and RA EDGE reports?

Answer: The RA state payment transfer, RA default charges (RADC), and RA proration reports will only be accessible on the External Data Gathering Environment (EDGE) Server Management Console to users with Issuer Approver roles in the Health Insurance Oversight System (HIOS). For information on accessing RA reports, issuers should review the RA Reports Job Aid at the following link https://www.regtap.info/reg_librarye.php?i=704. Additionally, most RA EDGE server outbound reports are generated when CMS executes a remote command to initiate the risk score and transfer extract batch job. After execution, the issuer's EDGE server generates and stores the following RA reports in the issuer's output directory during May: RA Risk Score Detail (RARSD), RA Risk Score Summary (RARSS), RA Transfer Elements Extract (RATEE) and RA Data Validation Population Summary Statistics (RADVPS) reports. The EDGE server generates the RA Claims Selection Detail (RACSD) and the RA Claims Selection Summary (RACSS) reports after the medical claim file ingest. CMS will also run a RA claims selection remote command against all accepted medical claims before we send the risk score and transfer extract batch job. When this remote command runs a new RACSD and RACSS report are generated

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