MA, Part D Plans Face Uncertainty as Audit Season Begins
Medicare Advantage, Medicare-Medicaid Plan and Part D sponsors selected for 2020 program audits will start receiving engagement letters this month, but they face some uncertainty as CMS has yet to finalize a set of proposed changes unveiled last August. While the bulk of those changes were aimed at reducing plan sponsors’ burden, plans are advised to closely monitor the data CMS may no longer collect through the audit process but may obtain from other sources, while continuing to conduct mock audits.
“Audit season is here, and March Madness means something different in the MA-PD world,” remarks Tina Bailey, vice president of compliance solutions with Gorman Health Group, LLC (GHG). “But this year the timing is odd as we’re waiting on new protocols…and we’re not sure what pieces of the proposed changes are going to be finalized and implemented this audit cycle.”
Related Posts
Through VBID Model, MAOs Tailor Interventions to Enrollees’ Evolving Social Needs
READ MORE
Reporting 1Q Earnings, Select ‘Insurtechs’ See Brighter Days Ahead With Focus on MA
READ MORE
News Briefs: CMS Reinterprets ‘Marketing’ Definition, Expands Materials Subject to Review
READ MORE
Meet Our Reporters
-
Lauren Flynn Kelly Executive Editor, AIS Health, and Managing Editor, Radar on Medicare Advantage
View Lauren Flynn Kelly's Profile -
Angela Maas Managing Editor, Radar on Specialty Pharmacy and Spotlight on Market Access
View Angela Maas's Profile -
Leslie Small Managing Editor, Health Plan Weekly and Radar on Drug Benefits
View Leslie Small's Profile -
Peter Johnson Reporter, Health Plan Weekly and Radar on Drug Benefits
View Peter Johnson's Profile -
Tim Casey Reporter, Health Plan Weekly and Radar on Drug Benefits
View Tim Casey's Profile -
Carina Belles Reporter, Radar on Medicare Advantage and Spotlight on Market Access
View Carina Belles's Profile -
Jinghong Chen Reporter, Health Plan Weekly and Radar on Drug Benefits
View Jinghong Chen's Profile
