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ExchangeAdministrativeMedium impact

Annual Medical Records Requests for Risk Adjustment Audit

EmblemHealth·Provider News
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply
—

Summary

EmblemHealth and ConnectiCare providers must respond to annual HHS Risk Adjustment Data Validation Audit requests from Cognisight, Inc. starting this summer. Providers must submit complete medical records for specified ACA exchange patients with dates of service from Jan 1 - Dec 31, 2022.

Action Required

Action needed
Beginning Summer 2023: When contacted by Cognisight, Inc., respond promptly with complete medical records for specified EmblemHealth/ConnectiCare ACA exchange patients (service dates Jan 1 - Dec 31, 2022). Use secure delivery method per Cognisight's instructions. If using medical records vendor, notify them now to ensure timely responses. No member authorization required.

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