Risk Adjustment User Group Session 2006/2007 Monthly Risk Adjustment User Group Session A training initiative presented by JULY 2007 1

Welcome to the July User Group Introduction Payment Process Data Validation Operations Update Training Update Questions and Answers Closing 2

INTRODUCTION 3

Introduction User Group Process All attendees must pre-register Panel will answer questions during the Q&A portion of the session Session will last for one hour Q&A document and session notes will be available within 2 weeks after the session Session slides will be available by the Tuesday before the session 4

PAYMENT PROCESS 5

Payment Process 2006 final scheduled for August payment Final 2006 and mid-year 2007 Model Output Reports (MOR) to be available mid-August 2004 and 2005 MORs to be available on July 26, 2007 2005 and 2006 ESRD reconciliation -- CMS testing ESRD status 6

DATA VALIDATION 7

Data Validation Calendar Year 2006 May 31, 2007: Notification letter distributed to selected MA organizations June 29, 2007: Instructions package sent to selected MA organizations July 11, 2007: Teleconference to orient selected MA organizations to RADV process August 17, 2007: Medical record submission deadline 8

Data Validation Calendar Year 2005 Second validation contractor (SVC) currently reviewing medical records – expected to conclude this month Organizations contacted by CMS to confirm provider credentials – responses required by COB on July 23, 2007 CMS anticipates releasing results in the fall of 2007 9

Data Validation Calendar Year 2004 QA process completed July 12, 2007: Plan-specific findings disseminated August 2007: Teleconference with MA organizations to communicate results 10

OPERATIONS UPDATE 11

502 DUPLICATE STATUS 12

TRAINING UPDATE 13

2007 Regional Training Schedule* Training Update 2007 Regional Training Schedule* August 7 – 9, 2007 Las Vegas, NV Register online at www.medicaretraining.net * Risk Adjustment session is closed 14

2007 Monthly Training Schedule* Training Update 2007 Monthly Training Schedule* Monthly training sessions will be available for September and October *Register online at www.medicaretraining.net 15

QUESTIONS AND ANSWERS 16

CLOSING 17

Resources Sean Creighton (Director, Division Risk Adjustment Operations) sean.creighton@cms.hhs.gov Henry Thomas (Training, Project Officer) henry.thomas@cms.hhs.gov Lateefah Hughes (Data Validation, Team Lead) lateefah.hughes@cms.hhs.gov Louis Johnson (FERAS, Risk Adjustment Coordination) louis.johnson@cms.hhs.gov Chanda McNeal (Payment Issues) chanda.mcneal@cms.hhs.gov LTC www.Medicaretraining.net CSSC www.csscoperations.com 18