When is the final reconciliation submission deadline for risk adjustment?

The final reconciliation submission deadline for risk adjustment is January 31 after the payment year. This date is significant because it marks the end of the reconciliation process, where health plans finalize their risk adjustment data and ensure that all necessary codings and adjustments have been completed for the previous year’s claims. This allows for accurate financial adjustments based on the risk profile of the enrolled population, which is essential for the correct distribution of payments to health plans.

This deadline ensures that all data submissions are completed in a timely manner, allowing for any necessary adjustments before final payment calculations are made for the upcoming fiscal periods. This timing aligns with critical reporting requirements and assists in maintaining compliance with federal regulations surrounding risk adjustment methodologies in healthcare.