Medicare AdvantageAdministrativeMedium impact
Provide Records To Support Risk Adjustment Data Validation Audits for Medicare Advantage
BCBS Montana·MT·Government Programs
Effective date
Mar 1, 2026
We identified it
Jun 18, 2026
Summary
Medicare Advantage providers must respond to medical record requests from Blue Cross Blue Shield of Montana and their vendor Advantmed for CMS Risk Adjustment Data Validation (RADV) audits beginning March 2026. Patient authorization is not required as this falls under healthcare operations.
Action Required
Starting March 2026: When receiving letters from Advantmed requesting medical records for RADV audits, respond as soon as possible with all records from the sampled year. No patient authorization required. Contact BCBSMT RADV department for questions. Audits are time-sensitive and validate risk adjustment payments to CMS.