Risk adjustment technology company RAAPID will host a C-suite focused webinar addressing the Centers for Medicare & Medicaid Services' historic expansion of Risk Adjustment Data Validation audits from approximately 60 Medicare Advantage plans to all 550 plans annually.

Webinar Details

Event: "Don't Wait for the Notice: How to Prepare for RADV Audits Now"
Date: June 20, 2025, at 11:00 AM EST
Registration Link: https://us06web.zoom.us/webinar/register/WN_dJ0YqkXnR8KYV_evNXrciQ#/registration
Who Should Attend: Healthcare executives, including CEOs, CFOs, compliance officers and risk adjustment leaders.

The Regulatory Shift

CMS's announcement represents an 800% increase in audit scope, featuring:

• Deployment of 2,000 medical coders
• Advanced analytical tools for comprehensive reviews
• Coverage of the entire Medicare Advantage ecosystem
• Substantial financial exposure for unprepared organizations

The Medicare Payment Advisory Commission estimates $40 billion in excess payments to Medicare Advantage plans compared to traditional Medicare.

Expert Commentary

"Organizations that have been gambling on audit avoidance now face mathematical certainty," said Wynda Clayton, MS, RHIT, Director of Coding and Risk Adjustment Leader at RAAPID and a seasoned RADV auditor and educator, with over 20 years of compliance experience who will lead the webinar presentation. "The question isn't whether you'll be audited—it's whether you'll survive the audit when it comes."

Key Webinar Topics

The 40-minute executive briefing will cover:

• Financial Risk Assessment: Multi-million dollar extrapolation scenarios showing how single audit findings cascade into enterprise-threatening exposure
• Crisis Prevention: Board-level frameworks for identifying vulnerabilities before CMS does
• Defense Strategies: Proven approaches that have protected health plans from devastating penalties
• Leadership Action Plan: Immediate responsibilities and critical questions for executive teams

Technology Arms Race

"CMS is essentially telling the industry: we're bringing sophisticated technology to this fight," noted Chris Lally, Vice President of Operations at RAAPID, who brings over 30 years of healthcare operations expertise. "Organizations that continue relying on manual processes are bringing calculators to a supercomputer battle."

CMS's Advanced Capabilities Include:

• AI-powered audit systems that process massive medical record volumes
• Pattern recognition that identifies documentation relationships
• Analytical tools that surpass traditional human review methods

Market Impact

Competitive Advantages for Prepared Organizations:

• Better provider support and reduced administrative burden
• Improved physician satisfaction with Medicare Advantage contracts
• Enhanced market positioning through compliance excellence

Risks for Unprepared Organizations:

• Significant financial penalties and clawbacks
• Damaged provider relationships
• Potential market share loss

Industry Implications

The RADV expansion creates a new reality where:

• Compliance excellence becomes a market requirement
• Technology infrastructure determines organizational capability
• Executive accountability extends to audit preparedness
• Manual processes become a competitive disadvantage

Expert Perspective

"We're providing crisis prevention strategies for executives who need to protect their organizations and stakeholders from regulatory catastrophe," Clayton emphasized. "Forty minutes today could save your organization millions tomorrow."

Registration Information

The complimentary webinar targets executives at:

• Medicare Advantage plans
• ACA health plans
• ACOs and value-based provider groups
• Third-party administrators

Registration is available through RAAPID's website as organizations face immediate audit selection and rapidly closing preparation windows.