Call for Authors: PPMC PG - Help us update the Medicare Advantage Risk Adjustment Toolkit

A subgroup of the PPMC is focused on tracking and following the False Claims Act cases, guidance and other developments related to Medicare Advantage risk adjustment. Risk adjustment is a risk mitigation tool that attempts to offset the cost of covering enrollees with greater health risk, and in turn, medical spending. In short, it is meant to level the playing field so that health plans compete against each other on price and quality while also disincentivizing adverse selection. Risk adjustment is used in the commercial market, Medicare, and Medicaid. The toolkit includes a summary of federal cases involving False Claims Act allegations around risk adjustment, identifies characteristics of the FCA cases, provides links to CMS guidance, news, congressional reports, and agency guidance related to risk-adjustment and centralized information related to Corporate Integrity Agreements in this area. This is an expanding and evolving area of the law. We are looking for volunteers to help keep the toolkit current and updated on a quarterly basis.