It’s time to start thinking about CMS audits

By Yvonne Zachman Fiedler
Tue, Dec, 18, 2018

As rules and regulations are continuously changing, health plans must navigate a complex and confusing framework to stay in compliance with CMS audits. While the Centers for Medicare and Medicaid Services hasn’t always been clear on certain aspects of Part C and Part D, the consolidation of two guide chapters into one comprehensive guidance document may soon offer more clarity in appeals guidance.

The final document isn’t expected to be released until the spring, but the draft CMS released in October hints to some changes that may be coming. Health plans should start reviewing the guidance now to see where their policies may fall short and how they may adjust them to ensure compliance in the coming year.


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