By Richard Schamp, MD, CEO

PACE organizations are accustomed to receiving final reconciliation of the prior year’s Part C and Part D payments in July.  This reconciliation is reflected in the Monthly Membership Report (MMR) and typically includes a positive true-up payment, especially if retrospective reviews were done in timely fashion.  However, this year the PY2016 reconciliation is delayed until October, as CMS communicated during their April CMS Risk Adjustment EDS & RAPS User Group presentation. The delay is due to…

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