While the 2020 Interim Final Run deadline remains Feb. 01, 2021, a recent Centers for Medicare & Medicaid Services memo officially sets the 2020 Final Run deadline to Aug 02, 2021, allowing Medicare Advantage Organizations six additional months to ensure a complete and accurate data submission.
On September 18, 2020, the Department of Health and Human Services Centers for Medicare & Medicaid Services issued the following message in a memo:
This memo is to notify Medicare Advantage Organizations, PACE Organizations, Medicare-Medicaid Plans, Section 1833 Cost Contractors and Section 1876 Cost Contractors, and Demonstrations of upcoming deadlines to submit risk adjustment data for use in calculating risk scores for Payment Years (PY) 2020, 2021, and 2022. CMS will be adding an additional reconciliation run for PY2020. All risk adjustment data (Risk Adjustment Processing System (RAPS) Data and Encounter Data System (EDS) Data) that will be included in the listed risk score runs need to be submitted by 8pm ET of the “Deadline for Submission.
While the 2020 Interim Final Run deadline remains Feb. 01, 2021; this memo officially sets the 2020 Final Run deadline to Aug 02, 2021, allowing Medicare Advantage Organizations six additional months to ensure a complete and accurate data submission. Final run deadlines have been extended before (in 2017, due to Hurricane Harvey), but not to this level of advance notice and duration. This creates a unique opportunity for health plans to complete secondary reviews of your previously coded charts from 2019 dates of service, perform an additional analytics run to identify unclosed HCC gaps, and launch a supplemental chart chase where low friction retrieval methods are available.
Step-by-step Timeline for Optimizing Your Additional PY2020 Reconciliation Run (2019 Dates of Service):
- September 2020 through January 2021 – Active chart retrieval & review operations with a transition to passive chart intake February through July. Continue chart review operations as charts are received.
- October 2020 through July 2021 – Leverage the additional six-months before the Final Run submission to improve your coding accuracy and completeness through 2nd level chart reviews.
- January 2021 – Analyze and identify any unclosed HCC gaps
- February 1, 2021 – Interim Submission deadline for PY2020
- February 2021 through March/April 2021 – Initiate a supplemental chart chase where low/no-abrasion retrieval methods are available (e.g., automated EMR extraction, contracted copy services, credentialed EMR remote access)
- April 2021 through August 2021 – Execute your chart retrieval and review operations for 2020 Dates of Service.
- August 2, 2021 – Final Submission deadline for PY2020
Ciox is ready to help MAOs optimize the opportunity afforded by the additional reconciliation. To learn more, click here.