The Medicare Timeliness Monitoring Project (TMP)—What to Expect?

CMS continues to conduct an industry-wide Timeliness Monitoring Project (TMP). This project is a retrospective review of 2022 data. It allows CMS to collect data to evaluate the timeliness of processing Medicare Part C reconsiderations, using the new TMP and audit protocols in place for 2022. As a reminder, this data is used to verify…

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2023 Star Rating Changes—CMS Advanced Notice for Review & Comment

CMS released the “Advance Notice of Methodological Changes for Calendar Year (CY) 2023 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies” on February 2, 2022, with feedback accepted until March 4, 2022. Some changes may impact Star Ratings for CY 2023. To submit comments or questions electronically, go to…

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Independent Validation Audits

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…

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