The first 2018 CMS audit notices have been sent…
By Julie Mason
If you are one of the “lucky” recipients, buckle your seat belt for the wild ride ahead. It takes stamina, acute attention to detail, speed, and a mountain of resources to navigate these program audits. Many Medicare Advantage and Part D plans engage external resources to guide them and/or supplement internal resources. If you go this route, select wisely; hiring a firm without extensive CMS audit experience can sometimes do more harm than good. Our MCS team is comprised of former CMS regulators who have conducted dozens of audits on the CMS side, former health plan executives and managers who have survived—and succeeded in—many CMS audits, and clinicians (physicians, pharmacists, and nurses) with extensive experience in clinical decision-making based on CMS coverage rules. We have leveraged this experience to help dozens of clients in the CMS audit process, both before, during and after the actual audit. Contact us to learn more.
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