How often are RADV audits conducted?

The frequency of RADV audits being approximately annually, but varying by plan, reflects the structured yet flexible nature of how these audits are scheduled. Each Medicare Advantage organization (MAO) is subject to its own unique contract terms and performance metrics, which can influence the timing and frequency of audits. While annual audits are the general expectation, certain circumstances, such as compliance issues or specific plan performance, might necessitate more frequent evaluations or adjustments to the standard timeline. This flexibility is crucial for ensuring that the integrity of risk adjustment data is maintained and aligns with the need for accurate reimbursement under the Medicare program. The variability emphasizes the importance of monitoring each plan's performance individually rather than adhering to a one-size-fits-all schedule.