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Text of Final HHS-Developed Risk Adjustment Model Algorithm 'Do It Yourself (DIY)' Software Instructions for the 2025 Benefit Year (PDF)
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS] Link to more items from this source
[Official Guidance]
Mar. 31, 2026

"This software is being issued only as a supplemental tool for issuers of risk adjustment covered plans to better understand and simulate the calculation of plan liability risk scores for their enrollees.... Python software is being phased in to replace the SAS software, which will be discontinued for benefit year 2026." Also available:

  • Technical Details (XLSX
  • 2025 Benefit Year Risk Adjustment: SAS Version of HHS-Developed Risk Adjustment Model Algorithm Software (ZIP)
  • 2025 Benefit Year Risk Adjustment: Python Version of HHS-Developed Risk Adjustment Model Algorithm Software (ZIP)

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