2017: A Year in the Trenches

Lessons Learned, Best Practices, and Key Takeaway Strategies for 2018 for CMS Audits

2017 proved to be another active audit year for Medicare Advantage and Part D plans. As a trusted advisor, Navigant has been actively supporting these plans with audits and audit readiness. Our Navigant team provides support during an actual Center for Medicare and Medicaid Services (CMS) audit, performs “mock” CMS Audits for audit readiness, Independent Validation Audits, Compliance Program Effectiveness audits and ongoing remediation and sanction efforts. New for 2017, CMS included the review of Call Logs as part of both the Part C and Part D program audit protocols. Additionally, audit activity also included focused audits by the Office of Inspector General on Fraud, Waste and Abuse and by the Department of Justice regarding Risk Adjustment payments.

Out of Navigant’s efforts and experience we offer lessons learned, best practices, and key takeaways strategies for plans and their First Tier, Downstream, and Related Entities to gear up for another strong year of audits in 2018.


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