Benefits of a Compliance Program Effectiveness Audit– Going Beyond Just Meeting the Requirement

By June 13, 2020Audits, CMS, CPE

CMS guidance requires Medicare Advantage Plans to have an independent audit of their compliance program’s effectiveness each year.  Given competing priorities, it may be tempting to conduct a limited or cursory audit or review of the compliance program.

However, engaging in a robust audit process that mimics the CMS process has far-reaching benefits for the compliance department and for the Plan. Some of these benefits include the opportunity for Plans to:

  • Identify gaps and realign priorities in risk assessments
  • Increase communication between the compliance department and operational business owners
  • Test the effectiveness of the monitoring and auditing work plan, including oversight of first-tier entities
  • Rehearse responding to auditor interview questions
  • Practice creating tracer summaries and successfully describing compliance processes
  • Detect and correct deficiencies before CMS does
  • Be audit ready when it is time for the real thing

Have you scheduled your 2020 CPE Mock Audit?

BluePeak’s seasoned auditors have a process for selecting tracers and targeting issues commonly identified by CMS.  We make it easy for you to meet your annual requirement AND provide the advice you need to strengthen your compliance program.  Contact us today to schedule your mock CPE.