MIPPA Sales Channel Audit

Open Enrollment has ended and it's time to take a breath... 

OK, break's over!  With the crush over, the time has come to assess the operational performance and compliance of your sales program--- CMS' #1 target. 

Yet as you well know, what defines "compliance" in Medicare Advantage is a moving target--- as evidenced by the flurry of new and far-reaching regulations released by CMS on the eve of this year's open enrollment.  But the regulatory volatility is no excuse for non-compliant sales activities. No area of MA and PDP operations has drawn more attention by CMS in recent years.  This "squeeze" is certain to continue.

Our team of former sales executives and regulators offer a flexible approach that will be designed to meet you organization's unique needs.  We can focus on your marketing plan, your sales channel, or both to give you the most comprehensive picture of your exposure.  We will then assist you in developing effective strategies for creative broker/agency contract review, sales and call center customer service and policies and procedures.

To determine if your organization needs a targeted audit, consider the following:

• Have you prepared your compensation policies and administration for 2010 enrollment?
• Are your policies and procedures audit-ready for this year's audit?
• If a CMS secret shopper attends a marketing event, do you know what they will hear and see?
• Can you document your compliance with new state appointment requirements?
• Are you documenting your scope of appointments correctly?
• Does your sales training and certification reflect the new MIPPA provisions?

For more information or to schedule a discussion, please contact us at (202) 364 8283.