CMS MEDICARE COMPLIANCE PROGRAM AUDITS
As part of contractual requirement with CMS, Medicare Advantage Prescription Drug (MAPD) plans to Medicare beneficiaries are required to establish and implement a compliance program that follows the guidelines outlined in Chapter 21 of the Medicare Managed Care Manual/Chapter 9 of the Prescription Drug Benefit Manual (Chapter 21/Chapter 9) with a goal to prevent, detect and correct Part C or D program non-compliance as well as fraud, waste and abuse (FWA).
Chapter 21/Chapter 9 requires that MAPD organizations should have the effectiveness of the compliance program assessed by an independent entity, such as an external organization, that is not part of the compliance department, to avoid self-policing.
Aqurate Health Data Management, Inc. has been effectively conducting these audits for MAPD organizations and is well positioned to offer these services. Our staff has thorough knowledge of CMS requirements and experience in conducting Medicare Compliance Program audits.
To learn more about Aqurate Health Data Management’s services, or to request a proposal please Contact Us