As Center for Medicare Services (CMS) announces expanded Risk Adjustment Data Validation (RADV) audits, Medicare Advantage (MA) plans are being pushed into a new operational reality. Compliance spot checks have evolved into an annual, high-stakes process with significant financial pitfalls tied to even small documentation gaps.
More auditors, more audits
Jason Jobes, Senior Vice President of Norwood Solutions, summed up the magnitude of this recalibration on LinkedIn, noting that CMS is expanding its team of RADV auditors from 40 to 2000 (a 50X increase) and they’ll be increasing patient record reviews from 2100 per year to 110,000 or more.
Extrapolated findings, increased risk
CMS is also broadening the scope of RADV audits. Annual audits are now expected across all eligible MA contracts, with larger chart samples—up to 200 per plan— and their extrapolated findings will apply to the entire population. In other words, one unsupported code in a handful of charts could now affect millions of dollars in payment recovery across the full contract.
Staying ready for the inevitable
Accelerated lookbacks to prior years (2018–2024) and new administrative requirements around documentation review, appeals, and ongoing compliance cycles mean plans must now operate with continuous audit readiness. This new pace puts pressure on compliance officers, clinical leadership, and financial forecasting teams alike.
Room to improve on every front
For MA plans working to manage RAF accuracy, reduce audit risk, and support primary care teams, the early detection and documentation of mild cognitive impairment (MCI) and dementia have become both a clinical mission and a compliance challenge. These frequently overlooked conditions carry high-value hierarchical condition codes (HCCs 125–127) but are among the most inconsistently identified and least well-documented diagnoses in outpatient settings.
That’s where Neurotrack adds critical value.
Despite being clinically and financially significant, cognitive conditions are often underdetected in routine care and poorly documented when identified. If limited to inefficient, subjectively scored pen-and-paper tests, providers (especially those in primary care) may hesitate to formally code MCI and dementia or may feel they lack proper documentation to back it up, especially under the weight of heightened audit scrutiny.
The result? Plans risk missed diagnoses, unsupported HCC codes, and audit-triggered recoupments—not because patients don’t need care, but because documentation may fall short of CMS’s standards.
Neurotrack’s digital cognitive screening platform is designed to meet this moment. It offers providers an easy-to-use, EMR-integrated solution that can identify cognitive impairment quickly and generate structured, audit-ready documentation in real time.
The platform’s clinical assessments are grounded in DSM-5 criteria and provide percentile-ranked scores across different domains, normalized by age, sex at birth, and education level. That means results are clear, objective, and defensible. In brief, Neurotrack’s reporting supports HCC documentation requirements.
What sets Neurotrack apart is how seamlessly it produces documentation aligned with the coding best practice known as MEAT (a way of detailing key steps in the diagnostic process):
All of this is generated instantly and may be embedded directly into the patient's chart.
Neurotrack’s value spans far beyond point-of-care screening.
In short, Neurotrack isn’t just a cognitive screening tool—it’s a strategic asset that helps MA plans defend diagnoses, reduce audit exposure, and maintain RAF integrity.
Without structured, evidence-backed tools like Neurotrack, teams may struggle with significant hurdles:
As CMS increases record sample sizes and extrapolates across populations, errors and inconsistencies can carry multimillion-dollar consequences.
And when we’re talking about neurocognitive disorders, as costly as they are complex, the financial risk only compounds when patients go undetected.
Neurotrack helps organizations prepare for RADV audits by doing more than catching cognitive impairment. The platform helps ensure diagnoses are based on standardized, objective data, and produces documentation that’s clear and defensible. In today’s audit environment, that’s not just a clinical win—it’s a business imperative.