Medicare AdvantageAdministrativeMedium impact
CMS Audit for Improper Payments to Spark Record Requests
Florida Blue·FL·Provider Bulletin
We identified it
Jun 16, 2026
Summary
CMS is conducting a national audit of 2024 Medicare Advantage payments and may request medical records for BlueMedicare HMO and PPO patients with 2023 service dates. Providers must be prepared to submit medical documentation when requested to validate risk adjustment payments.
Action Required
Immediately: Ensure medical records for BlueMedicare HMO and PPO patients with service dates from January 1 - December 31, 2023 are complete and readily accessible. Medical records staff should be prepared to respond promptly to record requests from Florida Blue Medicare for CMS audit purposes. Contact RPMChartProcurement@FloridaBlue.com with audit-related questions.