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Medicare AdvantageAdministrativeMedium impact

Medical Mutual No Longer Using RCV and CQV Apps in Availity

Medical Mutual of Ohio·In the News
Effective date
May 31, 2025
We identified it
Jun 20, 2026
Days to comply

Summary

Medical Mutual is discontinuing its Risk Condition Validation (RCV) and Clinical Quality Validation (CQV) applications in Availity Essentials effective May 31, 2025. Providers will no longer receive care gap and risk gap requests through the Availity portal but Medical Mutual will continue using alternative strategies for closing gaps in Medicare Advantage members.

Action Required

Action needed
By May 31, 2025: Remove RCV and CQV apps from Availity workflow processes for Medical Mutual Medicare Advantage patients. Staff should expect to receive care gap and risk gap closure requests through alternative methods (not specified yet). Monitor for new communication from Medical Mutual regarding replacement gap closure processes.