Updates for Risk Adjustment Inquiries to RiskAdjustmentOperations@cms.hhs.gov (RAO) and RiskAdjustmentPolicy@cms.hhs.gov (RAP) Mailboxes
PII and PHI inquiries:
PII and PHI, defined as data that specifically identifies a beneficiary, e.g. MBI number, must never be sent to CMS unless it is encrypted. If data is needed to identify a specific case, CMS prefers the ICN (Internal Claim Number), of the associated encounter(s) returned on the MAO-002 report, be used to communicate with CMS. The ICN can be used to identify the beneficiary preventing the need for the PII/PHI information. It is a violation of CMS' privacy guidance to send or receive unencrypted PII/PHI data. CMS accepts encrypted files in both the RAO and RAP mailboxes.
Acceptable Attachment File Extensions :
CMS is sending this notification to remind Medicare Advantage Organizations (MAOs) that the RAO and the RAP mailboxes accept only certain formats for attached files. The list of acceptable file extensions has been updated. CMS now accepts attachments with the following file extensions: bmp, csv, docx, eml, jpeg, jpg, msg, pdf, png, pptx, rpmsg, rtf, txt, xlsx and zip.
In the event you have questions, please contact CSSC Operations at 1-877-534-2772 (option 2) or by email at csscoperations@palmettogba.com.