Compliance & Performance Monitoring
Margin for error? There is none.
In recent months, CMS has radically changed its audit practices. Leveraging the Parts C and D data it has been collecting from your plan, CMS is identifying outliers and swiftly moving in with large audit teams, disrupting operations and beginning a lengthy period of corrective action.
Plans must now be on an audit footing at all times. This means closing the gap between your compliance officer and the rest of the organization. Compliance may be a department, but it is not a job function, like enrollment or medical management. It is an attitude that permiates every department, and is supported by proper tools and rigorous oversight.
Executives are wise to remember that most compliance issues begin life as operational issues. Compliance can therefore be seen as a warning system for operational inefficicies or threats to member satisfaction. Learn more about how we can help you here.
