If the Centers for Medicare and Medicaid Services (CMS) reviewed your procedures around Health Plan Management System (HPMS) memos tomorrow – would you be happy with the outcome?
Unfortunately for many health plans, the answer is, “No.”
With anywhere from 10 to 20 HPMS memos distributed each week, there’s a heavy burden on compliance departments to review, interpret and respond to these documents – and doing so properly doesn’t always happen.
Adding to the burden is the increased number of memos CMS is distributing each year. In 2015, CMS distributed 496 HPMS memos to plans – a 45 percent increase from 2013. This will only continue to grow as CMS increases oversight and establishes new reporting requirements.
Below are three ways to ensure that you are prepared for an audit of your HPMS memos:
1. Track required responses and due dates
With a number of HPMS memos requiring action within a specified timeframe, it’s important that plans are tracking required responses and due dates. This will ensure that there is a “paper trail,” should CMS come in and audit the plan’s response to HPMS memos.
2. Attach HPMS memos to the rules they impact
To increase visibility and ensure that all parties are aware of the full scope of regulatory changes, plans should attach relevant HPMS memos to the underlying rules and regulations that they impact. This will reduce your team’s risk of missing important updates.
3. Utilize software solutions
Software tools that help maintain a library of HPMS memos can also provide a number of benefits to health plans today. For instance, these tools will notify plans when new memos are released and automatically include them in the database. They can also notify key stakeholders of required due dates and ensure that the plan is compliant with the latest and most accurate information from CMS.
The CodySoft® HPMS Memo Module™ helps streamline the review, organization and response to HPMS memos issued by CMS. When integrated with the Regulatory Analyzer®, the HPMS Memo Module can also attach relevant HPMS memos to the underlying rules and regulations that they impact.