ExchangeAdministrativeMedium impact
Cognisight to Conduct HHS Risk Adjustment Data Validation Audit
EmblemHealth·Provider News
Effective date
Jul 1, 2022
We identified it
Jun 20, 2026
Summary
EmblemHealth and ConnectiCare providers must respond to medical record requests from Cognisight, Inc. for HHS Risk Adjustment Data Validation Audits. Cognisight will request complete medical records for specific ACA exchange members with dates of service from Jan 1-Dec 31, 2021.
Action Required
Immediately: Respond promptly to medical record requests from Cognisight, Inc. for EmblemHealth and ConnectiCare ACA exchange members with 2021 dates of service. Use secure delivery methods as instructed by Cognisight. Providers using medical record vendors should notify their service suppliers now to ensure prompt response to audit requests. No member authorization required due to existing business associate agreement.