CMS’s Part D Audit Findings: A Roadmap for Plan Sponsors

View Sample (PDF)

Highlights on this Page

Publication Details

  • Publication Date: 2011
  • Pub Code: BPDA2-11WEB
  • Pages: 32
  • PDF version: 216 KB
  • ISBN: 978-1-936230-13-6

3 Easy Ways to Order

  1. Secure Shopping Cart
  2. Call 800-521-4323
  3. Print a form to fax or mail

CMS’s Part D Audit Findings: A Roadmap for Plan Sponsors

A collection of summaries of CMS’s recent audit reports that will help Part D plans avoid becoming agency targets. It highlights the top audit hot spots and other areas that CMS and Medicare Drug Integrity Contractors have been focusing on — and will likely continue to focus on — during audits.

Place your order through our secure shopping cart

$84.00
$84.00

From the editors of Medicare Advantage News and Report on Medicare Compliance

As CMS continues to move from routine audits to more targeted, data-driven or risk-based audits of Medicare Part D plans, there are lessons to be learned from the mistakes of other plans.

CMS’s Part D Audit Findings: A Roadmap for Plan Sponsors will help Part D plans avoid becoming agency targets. This collection of summaries of CMS’s recent audit reports details what CMS and Medicare Drug Integrity Contractors have focused on in the past year — and will likely continue to focus on — during audits.

Industry trends point to these top audit hot spots:

  1. Enrollment eligibility/disenrollment
  2. Marketing
  3. Complaints, appeals and grievances
  4. Delegation oversight
  5. Compliance programs
  6. Training

CMS’s Part D Audit Findings: A Roadmap for Plan Sponsors highlights these and other audit areas, and includes a comprehensive table summarizing the status of Part D and MA-PD sponsors’ audits. Order your copy today, and start developing sound strategies to avoid becoming a high-risk plan on CMS's audit radar.

Table of Contents

Recent CMS Audit Reports

  • Aetna Inc.
  • Baystate Health, Inc.
  • Independent Health Association, Inc.
  • Universal American Corp.
  • Altamed Health Services Corp.
  • Rocky Mountain Health Care Services
  • Catholic Health System Buffalo
  • Northland Healthcare Alliance
  • Health Net, Inc.
  • Arcadian Management Services
  • Johns Hopkins Health System, Inc.
  • LifeCircles
  • Fox Insurance Co.
  • Community Health Partnership, Inc.
  • Life at Home, LLC
  • EmblemHealth

Table: Status of Sample of Part D and MA-PD Sponsors' Audits

Written By

This book was written by the editorial staff of AIS.

Written For

  • Health plan sponsors
  • PBMs
  • Pharmaceutical companies
  • Pharmacy chains
  • Consultants and attorneys
  • Hospital pharmacy managers and compliance officers
  • Other health care organizations with a major stake in Part D

Shipping Information

Print Version: This item is shipped via UPS. Please give us your street address when you order (UPS does not deliver to PO boxes.) You should receive your order within 5-7 business days. Shipping cost is $12 per item.

PDF Version: Immediately after submitting your order through our secure shopping cart, you will receive an e-mail with a link directing you to download the PDF file of the book. If you place your order via phone, fax or mail, the PDF version will be e-mailed to you when your order is processed (usually within 1 business day). Shipping costs will not be charged for this item.

Rush orders: Please call us at 800-521-4323 to place a rush order. We will overnight your order for an additional charge of $45, or you can give us your FedEx or UPS account number and we will charge the shipping to your account. Rush orders placed after 3:00pm EST will not be shipped out until the next business day.

View Sample (PDF)

CMS’s Part D Audit Findings: A Roadmap for Plan Sponsors

Place your order through our secure shopping cart

$84.00
$84.00

MarketPlace Search

View All AIS Products By

Featured Medicare Advantage and Part D Products