Compliance Consulting

Enhance Your Relationship with CMS

It’s no secret CMS has no tolerance for ineffective Compliance Programs or deficient performance within plans. Failure to meet regulatory compliance can have serious and costly consequences—from exorbitant penalties and sanctions to significant risk of a shut down for falling out-of-favor with CMS.

CODY® Compliance Consulting helps mitigate risk and ensure compliance—from organizational and structural design, program documents, and oversight to readiness auditing, incident management, and policy and procedures. We are here to support you, or we can do it for you:

  • Develop a Compliance Program that meets regulatory requirements
  • Assess your current Program—identify risks, recommend improvements, and help support the implementation
  • Build and/or support Operational and FDR oversight—CMS Mock Audits (ODAG, CDAG, SNPCC, FA, CPE), pre-delegation audits, FDR oversight audits, operational audits, and monitoring activities
  • Compliance Policy Development and Review, Compliance Training, Readiness Reviews, and Risk Assessments
  • Part C and Part D Annual Reporting Development and Review
  • Part C and Part D Reporting Data Validation
  • Hands-on support in developing and implementing Corrective Action Plans (CAPs) to cure deficiencies identified in audits
  • CMS Independent Validation Auditor (IVA)
  • Provider Data Accuracy Review
  • Call Center Audit and Monitoring

Client Testimonial:

“I want to take a moment to applaud your team for helping us on the Data Validation Audit (DVA). Had the scoring issue not been identified, we would have failed Special Needs Plan (SNP) and grievances. CODY® has been a pleasure to work with and a true asset for us. Your whole team has been great, and I have learned a lot.”

Midwest Medicare Advantage Plan

Audit Support

Our Services