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

Issue Date: January 22, 2019

Program Area: Risk Adjustment (RA)

Question: Can the Centers for Medicare & Medicaid Services (CMS) advise where issuers may find Hierarchical Condition Category (HCC) tables for Benefit Year 2017?

Answer: CMS provided the HHS-Developed Risk Adjustment Model Algorithm "Do It Yourself (DIY)" Software Instructions located at the following link: https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/DIY-Instructions-2017-RA-7-20-17.pdf DIY tables document with the ICD-10 to HHS-Condition Categories Crosswalk located on table 3 at the following link: https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/DIY-Tables-7-12-2017.xlsx. The 2018 Benefit Year DIY Instructions are located at the following links; Updated 2018 DIY Instructions https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/CY2018-DIY-instructions.pdf Technical Details www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/2018-RA-Model-DIY-Tables.xlsx Updated 2018 SAS Software https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/HHS-HCC-software.zip

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