Coding Intensity Adjustment Factor Sample Clauses

Coding Intensity Adjustment Factor. 4.2.4.2.1 In calendar year 2014, CMS will calculate and apply a coding intensity adjustment reflective of all Demonstration Enrollees except as indicated in Section 4.2.4.2.3. This will apply the prevailing Medicare Advantage coding intensity adjustment proportional to the anticipated proportion of Demonstration Enrollees in 2014 with Medicare Advantage experience in 2013. Operationally CMS will still apply the full prevailing Medicare Advantage coding intensity adjustment factor to the risk scores but will increase the Medicare A/B Component for non-ESRD beneficiaries and beneficiaries with an ESRD status of functioning graft, to offset this.
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Coding Intensity Adjustment Factor. 4.3.4.2.1. CMS will calculate calendar year 2014 rates as if the coding intensity adjustment factor were not applied, to reflect the fact that virtually all Enrollees were receiving care in FFS Medicare and thus there should be no coding pattern differences for which to adjust. Operationally CMS will still apply the coding intensity adjustment factor to the risk scores but will increase the Medicare A/B baseline for non-ESRD beneficiaries and beneficiaries with an ESRD status of functioning graft, to offset this.
Sample 1

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