---
kind: "section"
citation: "45 C.F.R. § 153.350"
title: "45"
number: "153.350"
heading: "Risk adjustment data validation standards."
url: "https://uscodex.org/cfr/45/153.350"
---

# §153.350. Risk adjustment data validation standards.

- (a) **General requirement.** The State, or HHS on behalf of the State, must ensure proper implementation of any risk adjustment software and ensure proper validation of a statistically valid sample of risk adjustment data from each issuer that offers at least one risk adjustment covered plan in that State.
- (b) **Adjustment to plan average actuarial risk.** The State, or HHS on behalf of the State, may adjust the plan average actuarial risk for a risk adjustment covered plan based on errors discovered with respect to implementation of risk adjustment software or as a result of data validation conducted pursuant to [paragraph (a)](#a) of this section.
- (c) **Adjustment to charges and payments.** The State, or HHS on behalf of the State, may adjust charges and payments to all risk adjustment covered plan issuers based on the adjustments calculated in [paragraph (b)](#b) of this section.
- (d) **Appeals.** The State, or HHS on behalf of the State, must provide an administrative process to appeal findings with respect to the implementation of risk adjustment software or data validation.

## Notes

### Authority

Authority: 42 U.S.C. 18031, 18041, and 18061 through 18063.

### Source

Source: 77 FR 17245, Mar. 23, 2012, unless otherwise noted.