What’s Possible After a Program Audit?
by Sue Dahlkamp, Interim Compliance Officer & Senior Consultant
CMS requires that sponsoring organizations undergo an Independent Validation Audit (IVA) if they receive a number of ICARs or CARs on their Program Audit to demonstrate correction of all reported audit conditions. CMS then determines when the audit can be closed based on the results of the Independent Validation Audit and any supplemental information provided by the sponsoring organization.
- Madena can assist plans with the CMS IVA process. While guiding you through the process, our SMEs will work with your team to develop a custom, CMS-approved validation work plan, conduct the validation audit and provide the validation report to be shared with CMS…and get you back in compliance.
- We work collaboratively with plans to develop our audit work plan. The work plan will cover required universes, sample sizes, audit period, and sample selection methods that target testing the corrective action outcomes required to be audited and be reviewed with CMS prior to the audit.
- We will begin the audit after your plan’s revised operations are in place and you are operationally “clean”, focusing to complete your audit in an efficient and timely manner to meet the CMS’ required deadline.
- Madena is a recognized leader in performing Compliance and Program Audits and is uniquely qualified to conduct IVAs. Our team includes SMEs in Medicare Part C and Part D who have audited Medicare compliance for years. Our audit systems and tools will address testing of correction of deficiencies identified by CMS.
- We have also conducted many FDR audits so are familiar with and have SMEs in all the delegated areas as well. So, if your FDRs are the problem, we can support that too.
- Madena provides post audit guidance and support, making sure you stay compliant.
Since 2012, Madena has bridged the knowledge gap between health plans serving the Medicare market and the government agencies they contract with. We understand the complexity of working with government healthcare programs. Our team has been leading and advising in the industry for decades—and we’ve got the tools and resources to serve you.