Medicare AdvantageAdministrativeMedium impact
CMS to Conduct Risk Adjustment Data Validation Audit for 2019 Service Dates
Florida Blue·FL·Medical Policy
Effective date
Apr 1, 2026
We identified it
Jun 16, 2026
Summary
CMS is conducting a risk adjustment data validation (RADV) audit for Florida Blue Medicare Advantage members with 2019 service dates. Providers may receive medical records requests between April-August 2026 and must respond within 10 business days, with all records due within 45 days of the original request.
Action Required
Between April-August 2026: Respond to any Florida Blue RADV audit medical records requests within 10 business days of receipt. Provide complete medical records with progress notes for BlueMedicare HMO and PPO members with 2019 service dates. All records must be submitted within 45 days of original request. Contact RPMChartProcurement@FloridaBlue.com with questions.