Risk adjustment audits are changing again, and leaders in charge of risk adjustment services should take note as the implications are massive.
In October 2025, a federal court struck down the Biden administration’s 2023 Risk Adjustment Data Validation (RADV) audit overhaul, unraveling a key regulation that would have significantly expanded Medicare Advantage (MA) plan audit recoveries. For payers, providers, and revenue cycle leaders managing risk adjustment operations, this decision adds a fresh layer of uncertainty – but also
