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.
PY2020 Sample Sizes Range from 35 to 200 Enrollees Per Contract
CMS assigns sample sizes based on contract size. The top 10 contracts receive 200 sampled enrollees; the next tier receives 100, then 50, with smaller contracts receiving 35. In PY2019, all contracts received 35. For larger plans, the jump to 200 represents a nearly 6x increase — hundreds of charts, thousands of dates of service, and surge demand that internal teams are rarely staffed to absorb alongside routine risk adjustment workflows.
This Isn't One Audit. It's Years of Overlapping Pressure.
CMS has published an official MA RADV audit schedule covering six payment years — PY2020 through PY2025 — launching approximately every two to three months from March 2026 through August 2027. For plans with multiple contracts, near-simultaneous Con-RADV audits will run concurrently with ACA HHS-RADV and ongoing retrospective coding cycles.
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.
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.
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.
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.
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.
