Care, Capture, Growth, Flow: 2026 Risk Adjustment Deadlines and a Five-Month Framework for Medicare Advantage Plans By Subbu Ramalingam, Managing Director, Risk Adjustment, Stars & Quality, ATTAC Consulting Group Originally published in the Vivega Health newsletter on August 6, 2026. Read the original here → The Star
Read More →By Tina Gallagher, Network Strategy & Development Program Lead, ATTAC Consulting Group I just returned from the 15th Medicare Stars, HEDIS®, Quality & Risk Summit, and one theme ran through nearly every session I attended: the conversation around provider access has fundamentally changed. It wasn’t coming from one presenter or one
Read More →By Lisa Hardisty, Senior Director, Compliance Solutions, ATTAC Consulting Group At a recent SNP conference, I asked a few plan representatives a direct question: “Have you taken your Model of Care, broken it down element by element, and checked that everything you committed to is actually reflected
Read More →Section 6220 of the Consolidated Appropriations Act, 2026, also known as the REAL Health Providers Act, is already signed into law. CMS and ONC held a public stakeholder meeting on it this month and are now collecting written comments directly by email, with new Medicare Advantage provider
Read More →By Tina Gallagher, Network Strategy and Development Program Lead, ATTAC Consulting Group Chicago last week reminded me that this industry, at its best, is a community, not just a market. At the 15th Medicare Stars, HEDIS and Risk Adjustment Conference, the energy felt different. Sessions went deep,
Read More →By Regan Pennypacker, MSL, SVP, Compliance Solutions The Centers for Medicare & Medicaid Services released the CY2027 Final Rule on April 2, 2026. For compliance officers, three key areas carry operational weight: sales and marketing, eligibility for Special Supplemental Benefits for the Chronically Ill (SSBCI), and debit card supplemental benefit
Read More →CMS released the CY2027 Medicare Advantage Final Rule and Rate Announcement within four days of each other. Together, they represent a systematic restructuring of how Medicare Advantage organizations will compete, be evaluated, and be paid. This guide covers six areas of change: what shifted, what’s at stake,
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Quick answer: CMS’s MA RADV audit calendar runs six overlapping payment years, PY2020 through PY2025, launching roughly every two to three months from March 2026 through April 2027. Audits are non-sequential: PY2024 initiates before PY2023 and PY2022. PY2020 and PY2021 are already active. ACA HHS-RADV and HEDIS
Read More →Why element-level scoring is the new hurdle for SNPs As we navigate the long and winding road of 2026, a new deadline is fast approaching: the May 2026 submission window for CY 2027 guidelines. The Model of Care (MOC) has evolved into a high-stakes precision test where
Read More →The landscape of Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) has undergone a seismic shift. CMS is no longer just sampling the industry; they are auditing every eligible contract, every year. With federal estimates indicating roughly $17 billion in annual overpayments due to unsupported diagnoses, the
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