CMS Audit Updates—Proactive Steps to Ensure Readiness & Maintain Compliance

Success in any CMS audit depends on being prepared to ensure readiness and maintain compliance throughout the year. Taking proactive steps now to support future CMS audits will produce better results and experiences for health plans and create a greater level of confidence for participants. New Audit Protocols for CY2022 Earlier this year, CMS released…

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How to Mitigate Compliance Risk & Improve Operations—An A-to-Z Approach

As the Centers for Medicare and Medicaid Services (CMS) increases its scrutiny and escalates enforcement, Compliance managers are on guard to ensure regulatory standards are met—and fines, sanctions, or even termination from CMS programs, are avoided. How can Compliance and Operations managers mitigate compliance risk and improve operations? The best way to avoid compliance errors…

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Are Your Policies and Procedures Audit-Ready?

Policies and procedures are essential tools for any organization. By clearly articulating the requirements established by external oversight bodies and internal standards, they are an effective control to support consistency, accountability, and compliance. To be effective, policies and procedures should be: Designed as tools that help employees make decisions related to their assigned tasks/responsibilities; Clear,…

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