Sources and Citations
Every regulatory and financial claim on this site is grounded in primary public sources. The references below are the authoritative documents we rely on for statements about the RxHCC model, Medicare Part D risk adjustment, prior authorization rules, and audit programs. Where possible we link to section landing pages, which CMS and other agencies keep stable even as individual documents are updated each year.
CMS CY2027 Rate Announcement
URL: https://www.cms.gov/medicare/payment/medicare-advantage-rates-statistics/announcements-and-documents
The annual Rate Announcement is the final notice through which CMS publishes Medicare Advantage and Part D payment parameters for the coming contract year, including the RxHCC model version, normalization factors, and frailty factors. It substantiates our statements about CY2027 RxHCC model changes, coefficient updates, and Part D payment methodology.
CMS Risk Adjustment Model Software and Factors (Part C and Part D)
URL: https://www.cms.gov/medicare/payment/medicare-advantage-rates-statistics/risk-adjustment
This CMS page hosts the official risk adjustment model software, rate calculations, and published coefficients for both the CMS-HCC (Part C) and RxHCC (Part D) models. It is the primary source for any condition category lists, hierarchies, disease coefficients, and model segment details referenced on this site.
MedPAC March Report to Congress — Part D Chapters
URL: https://www.medpac.gov/document-type/report/
MedPAC's annual March Report to the Congress on Medicare payment policy includes dedicated chapters on the Medicare Advantage program and the Part D prescription drug benefit. These chapters substantiate our claims about Part D plan liability under the Inflation Reduction Act redesign, reinsurance and risk-sharing mechanics, and the financial pressures facing Part D sponsors.
KFF Medicare Advantage and Part D Explainers
URL: https://www.kff.org/medicare/
KFF (Kaiser Family Foundation) publishes independent, nonpartisan explainers and data briefs on Medicare Advantage enrollment, Part D benefit design, and the $2,000 out-of-pocket cap. We cite KFF analyses to corroborate enrollment trends, beneficiary cost-sharing changes, and the market context behind Part D risk adjustment strategy.
CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F)
URL: https://www.cms.gov/newsroom/fact-sheets/cms-interoperability-and-prior-authorization-final-rule-cms-0057-f
The CMS-0057-F final rule establishes prior authorization turnaround time requirements (72 hours for expedited requests, 7 calendar days for standard requests) and mandates prior authorization APIs for impacted payers beginning in 2026-2027. It substantiates all statements on this site about prior authorization deadlines, automation requirements, and utilization management compliance obligations.
CMS Risk Adjustment Data Validation (RADV) Program
URL: https://www.cms.gov/medicare/payment/medicare-advantage-rates-statistics/risk-adjustment-data-validation-radv
The RADV program page describes how CMS audits risk adjustment data submitted by Medicare Advantage and Part D plans, including medical record review, payment error calculation, and extrapolation of overpayments. It is the authoritative source for our statements about audit exposure, documentation requirements, and overpayment recovery risk.
A note on accuracy
Regulations and model specifications change annually. If you spot a claim on this site that appears outdated or inconsistent with a current CMS publication, let us know at hello@curafi.com and we will review and correct it.