ExchangeAdministrativeMedium impact
ACA annual risk-adjustment outreach supports equal access to care for your patients
Cigna·Medical Policy
We identified it
Jun 18, 2026
Summary
Cigna Healthcare will request patient medical records from providers as part of mandatory ACA risk-adjustment program compliance and RADV audits. Providers are required to respond to these requests, which may occur twice annually and will recur each year.
Action Required
Establish process to respond to Cigna Healthcare medical record requests for ACA risk-adjustment and RADV audits. Staff should be prepared to provide objective assessment and plan documentation (SOAP notes minus subjective portion) when requested. Sensitive data can be omitted. Requests may occur twice annually starting each January.