FDR Oversight – Turning Policy & Procedure into Practice
Health plans (collectively, “plan sponsors”) that contract with the Centers for Medicare & Medicaid Services (CMS) to provide health services […]
Audit & Monitoring
How to Master CMS Audit Preparation
CMS Audit preparation aren’t something you can cram for at the last minute and expect good outcomes. If health plans
Forewarned is Forearmed: Prepare for 2021 CMS Audit Protocols Change
While the world is anything but predictable—especially in the age of COVID-19—the Centers for Medicare and Medicaid (CMS) isn’t being
CMS Program Audit Universes as a Tool for Ongoing Compliance Monitoring
One of the most arduous and time-consuming activity for MAPD and PDP plans is the creation of the required universes
2015/2016 CMS Program Audit Protocols and Process Updates
CMS program audit evaluate the performance of the Medicare Advantage/Prescription drug plans (MAPDs) and prescription drug plans (PDPs) that provide
2015 CMS Audit Protocol: Your Takeaway
In early February, the CMS released its new audit protocol and process updates for 2015 for Medicare Advantage organizations and