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No. For the Exchange product line, COVID-19 is not included in the Plan All-Cause Readmissions (PCR) risk adjustment calculations.
References of COVID-19 in the “Risk Adjustment Determination” narrative and introductory text of the Risk Adjustment Calculation section is an error. The PCR COVID-19 related discharge adjustments only apply to the Medicare product line for MY 2026.
This applies to the following Programs and Years:
Exchange MY 2026
