Common use of Risk Adjustment Methodology Clause in Contracts

Risk Adjustment Methodology. A. The Medicare A/B Demonstration county rate will be risk adjusted based on the risk profile of each enrolled beneficiary. Except as specified in section II.B.g, the existing CMS-HCC risk adjustment methodology will be utilized for the Demonstration. B. The Medicare Part D national average bid will be risk-adjusted in accordance with existing Part D RxHCC methodology. C. The Medicaid component will be risk adjusted based on a methodology as described in section I above.

Risk Adjustment Methodology. A. The Medicare A/B Demonstration county rate will be risk adjusted based on the risk profile of each enrolled beneficiary. Except as specified in section II.B.gsections II.B.d and II.B.g of this Appendix, the existing CMS-HCC risk adjustment methodology will be utilized for the Demonstration. B. The Medicare Part D national average bid will be risk-adjusted in accordance with existing Part D RxHCC methodology. C. The Medicaid component will be risk adjusted based on a methodology proposed by the State and agreed to by CMS as described above in section I above.Section I.