Learn · Medicare · RADV · Horizon Aegis

Don't book vacated extrapolation as a CMS recovery.

If a pitch treats nationwide RADV extrapolation as current law, it is selling a vacated rule. We will not do that.

What was vacated

The 2023 RADV Final Rule's nationwide extrapolation was vacated in Humana v. Becerra. Sample-only exposure is the honest figure on a live briefing.

What JIL still offers

B11 (mean + finite-population correction + Student-t 90%) is coded and held ready, not active. It is a self-ID / reserve scenario. It is never a booked CMS liability.

How Horizon Aegis talks about money

Simulated sample exposure. Stress tests. Labels say model exposure. They do not say 'CMS will take this.'

FAQ

Can we run a B11 scenario?

Yes, as a scenario. The flag defaults off. Do not book it.

What number belongs in a board pack?

Sample-only V22/V24 support findings. Not vacated nationwide extrapolation.