Know What You're Facing

MA RADV Coding Is Fundamentally Different

Many plans underestimate how different MA Con RADV HCC validation coding is from standard retrospective coding. That gap is where audit risk grows. The methodologies, documentation standards, and coder skill sets required are not interchangeable.

Standard Retrospective Coding
Capture an HCC once on a single date of service
General CMS HCC coding guidelines apply
Volume-focused, linear review workflow
No need to rank or compare individual records
A single pass per chart is typically sufficient
MA Con RADV HCC Validation Coding
Code every HCC on every date of service within the record, not just once
Rank documentation quality on a 1–3 scale per HCC, per date of service
Identify the best 2 records per HCC for CMS submission
Surface previously unsubmitted HCCs that could offset variance
Manage multiple HCC model versions (V22–V28) simultaneously
200+

CMS May Sample Up to 200 Enrollees Per Contract

Under current CMS methodology, plans may face samples of up to 200 enrollees per MA contract, compared to just 35 in earlier cycles. For larger contracts this means hundreds of charts, thousands of dates of service, and surge demand that internal teams are rarely staffed to absorb alongside routine risk adjustment workflows.

The Bigger Picture

This Isn't One Audit. It's Years of Overlapping Pressure.

CMS has announced plans to conduct MA RADV audits across multiple payment years on an expedited, cascading schedule, with a new payment year launching approximately every three months. For plans with multiple contracts, near-simultaneous audits across several payment years will run concurrently with ACA HHS-RADV and ongoing retrospective coding cycles.

2026–2027 Risk Adjustment Audit Landscape: MA RADV audit cycles PY2020–PY2025 running Mar 2026 – Aug 2027, ACA HHS-RADV, and HEDIS Hybrid Chart Review running simultaneously
PY2020
Mar – Jul 2026
PY2021
May – Sep 2026
PY2024
Aug – Dec 2026
PY2023
Nov 2026 – Mar 2027
PY2022
Jan – May 2027
PY2025
Apr – Aug 2027

MA RADV only. ACA HHS-RADV and HEDIS cycles also running. Est. per CMS audit calendar.

Est. timeline based on CMS audit calendar. Compiled by ATTAC Consulting Group / Validira.

Bottom line: For most of 2026 and into 2027, plans will be managing two MA Con RADV audits simultaneously, on top of ACA HHS-RADV, retrospective coding, and routine risk adjustment submission cycles. The operational demand is extraordinary. Validira was purpose-built for exactly this environment.
Validira · An ATTAC Solution

Proven at Scale

Validira has supported MA Con RADV audits across the country since the program's earliest cycles. These numbers reflect what we deliver.

10%+
Of All H-Contracts Nationwide
In the PY2019 audit cycle, Validira coded medical records for more than 10% of all MA contracts selected by CMS, making us one of the most widely deployed MA RADV coding teams in the country.
Validira internal engagement data, PY2019 cycle
~98%
Coding Accuracy
Internally measured coding accuracy and completeness across all RADV engagements in CY2025, reflecting our multi-stage QA process and specialized coder depth on every record.
Validira internal QA measurement, CY2025
8%+
New Submittable HCCs Identified
In the PY2019 cycle, our coders identified new HCCs beyond those originally submitted by plans. Finding legitimate upside can meaningfully offset variance and improve audit outcomes.
Validira internal engagement data, PY2019 cycle
Why Validira

Built for MA RADV. Ready When You Are.

Validira from ATTAC Consulting Group is a specialized MA Con RADV coding and audit management solution, not a generic coding shop pressed into audit service. We've been doing this for nearly a decade, and our entire infrastructure is designed for the complexity that MA RADV demands.

🎯
Rapid Audit Launch
Pre-audit planning is built into our operating model. Upon receipt of your audit data, Validira is ready to mobilize coding within days, not weeks. No ramp-up delays when the clock is running.
🤖
NLP + AI-Enabled Coding Platform
Our proprietary platform enhances HCC documentation location and manages all applicable model versions (V22–V28) simultaneously, increasing both speed and coding accuracy across every record.
📊
Cycle Management Reporting
24/7 portal access with real-time validation status, documentation strength rankings, and Power BI-enabled custom views so your team always knows exactly where you stand.
🔍
New HCC Identification
Our coders routinely surface submittable HCCs not captured in original submissions. In the PY2019 cycle, that rate exceeded 8%, upside that can meaningfully improve a plan's variance calculation.
📋
Chart Retrieval Support
Through our retrieval partner network, Validira can manage the full medical record chase nationally, reducing coordination burden on your team during an already demanding period.
🔒
HITRUST Certified Security
All data stored in U.S.-based encrypted facilities. No offshore storage, ever. Our HITRUST CSF certification covers our entire RADV platform and end-to-end data handling process.
“

ATTAC has been a game-changer for us. They are agile, responsive, and willing to bend over backwards to provide us with what we need. Compared to past audit partners, the experience has been night and day. We only wish we had brought them on sooner.

Plan Executive  ·  Top 5 National Health Plan  ·  MA Con RADV Client
🛡
HITRUST CSF CertifiedCovers our full RADV platform
🇺🇸
100% U.S. Data StorageNo offshore data, ever
🔐
SSL + Dual-Factor AuthRole-based access on all data
⚡
sFTP + Secure PortalEncrypted transmission, in and out

CMS is ready. Validira is ready. Are you?

The audit calendar is set. Our coding teams are standing by. The only variable is whether your plan has the right partner in place before notices arrive.

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