CMS Temporarily Suspends Contract-Level RADV Audits

by  Aimee Wilcox, CPMA, CCS-P, CST, MA, MT
April 15th, 2020

On March 30, 2020, the Centers for Medicare and Medicaid Services (CMS) announced to all of the Medicare Advantage Organizations and Part D Sponsors that effective immediately, it is suspending contract-level RADV audits, related to the payment year 2015 and will not initiate any new ones until after the public health emergency has ended. 

This is another example of how the federal government is trying to ease the burdens of providers and payers tasked with the main responsibility of providing healthcare and coverage, respectively, for hundreds of thousands of U.S. citizens affected by COVID-19. However nice this temporary reprieve may be, it is vital to remember that it is only temporary and that the auditing work of CMS will not completely come to a screeching halt.

The CMS notice reminds us that although there is a temporary reprieve for the 2015 audit, they will continue to allow payers to submit medical documentation they have already received from providers. CMS will also review any of the medical records already submitted or that will be submitted for the 2014 audit. Because of this, CDAT will remain open for record submission and payer feedback. 

Although CMS is not beginning any new audits, it is important to realize they now have a little more time to scrutinize the records they do have, especially for the 2014 audit, so be sure to watch for organizational feedback that may be a bit more detailed or refined that has been in the past. As a payer organization, take the time to fortify compliance plans, education, and to carefully review the feedback CMS sends to your organization and apply it towards the 2015 audit that will begin after the current crisis has abated. Be sure to take advantage of the many tools and resources available in to prepare for when the temporary suspension is lifted. 

For additional information related to contract-level RADV audits, contact CMS at


CMS Temporarily Suspends Contract-Level RADV Audits. (2020, April 15). Find-A-Code Articles. Retrieved from

© InnoviHealth Systems Inc

Article Tags  (click on a tag to see related articles)

Publish this Article on your Website, Blog or Newsletter

This article is available for publishing on websites, blogs, and newsletters. The article must be published in its entirety - all links must be active. If you would like to publish this article, please contact us and let us know where you will be publishing it. The easiest way to get the text of the article is to highlight and copy. Or use your browser's "View Source" option to capture the HTML formatted code.

If you would like a specific article written on a medical coding and billing topic, please Contact Us.


innoviHealth Systems, Inc.
62 East 300 North
Spanish Fork, UT 84660
Phone: 801-770-4203 (8-5 Mountain)
free demo
request yours today
free subscription
for any budget

Thank you for choosing Find-A-Code, please Sign In to remove ads.