PDP Compliance
Like their Medicare Part C counterparts, PDPs have a host of compliance issues to address on an ongoing basis.
The rapid changes in Part D regulations make tracking of these requirements exceptionally difficult--- to say nothing of actually managing to them. This difficulty is magnified by many PDPs’ reliance on delegated entities to perform the core functions of the benefit. Because CMS has not audited a great number of PDPs in recent years due to budget constraints, the industry can expect a far more robust effort in the near future, as funding to the CMS for this purposes is expected to increase under the new administration and CMS administrator.
Gorman Health Group has prepared numerous sponsors of all sizes prepare for a Part D audit, whether it is by performing gap analyses that measure your program against where it should be, or by providing mock audits that mimic the experience of having CMS comb through your contracts, performance, policies and procedures. And all of our engagements are conducted with the mentorship of your staff in mind.
Our consultants provide a mix of counsel and “do-it-yourself” tools that will ensure your compliance department and executives have access to better information, faster; this means that instead of chasing data points, you can spend your time on the things that will actually affect your score when a CMS audit comes---and it always does.
