Risk Adjustment: How to Navigate the Regulatory and Litigation Landscape During the Pandemic

June 9, 2021 3:00pm

J. Gabriel McGlamery
Senior Health Care Policy Consultant, Government Relations
Florida Blue

Michael S. Kolber
Manatt, Phelps & Phillips LLP

  • Exploring the regulatory and enforcement developments in risk adjustment as it relates to the current COVID environment
  • Identifying key takeaways from actions by insurers against CMS for alleged underpayment as well as regulatory actions for overpayment
  • Examining differentiation of market segments and how commercial risk adjustment is drifting away from adverse selection
  • The evolution of RADV – what was fixed and what’s still broken