Don’t Miss the 2021 NOIA Deadline

Don’t Miss The 2021 NOIA DEADLINE By Janet Eisenberg, Vice President The Contract Year 2021 application process with CMS requires detailed planning and enough lead time to efficiently meet application deadlines. With over 150 combined years of experience and...

Medicare Advantage: Not Too Soon for Spring Training

Medicare Advantage: Not Too Soon For Spring Training By Julie Mason, Principal In the midst of baseball’s post season, I can’t help but compare CMS program audits to America’s favorite pastime.  Medicare Advantage (MA) and Prescription Drug Plans that weren’t audited...

2020 CMS Program Audit Overview

2020 CMS Program Audit Overview  By Yvonne Tso, Vice President First, some good news: as of August 25, 2019, if a sponsoring organization (“Sponsor”) has not been notified by the Centers for Medicare & Medicaid Services (CMS) of an upcoming audit, it is safe to...

Getting Clarification from CMS

Getting Clarification from CMS By Jen Sousa, Vice President Between the Code of Federal Regulations (CFR), Part C and Part D guidance manuals, and HPMS memos, there are literally thousands of pages of material to memorialize CMS’ requirements and expectations. Yet we...

FDR Compliance/FWA Training: CMS Contradicts Itself

FDR Compliance/FWA Training: CMS Contradicts Itself By Julie Mason, Principal As a best practice to document compliance with the latest Centers for Medicare and Medicaid (CMS) compliance program requirements, some Medicare Advantage organizations (MAOs) may make use...