WASHINGTON, August 21, 2012 – Gorman Health Group (GHG), the leading solutions provider in Government health care programs, announces today its first client to contract for its offsite virtual audit program. The first of its kind in the Medicare Advantage and Part D industry, the GHG program facilitates the auditing program that CMS requires of Medicare Advantage and Part D organizations.
CMS requires that every contracted organization have in place an audit work plan that addresses the risks associated with administration of Part C and Part D benefits. GHG now offers a cost effective audit program that evaluates compliance with Regulations, CMS Guidance and internal policies and procedures to protect against noncompliance and Fraud Waste and Abuse.
“It is getting harder for even the best organizations to stay in compliance with fast moving federal regulations, especially with the extreme budgetary pressures caused by reduced payments to Medicare Advantage,” said Nathan Goldstein, Chief Executive Officer of Gorman Health Group. “Our program provides plans with the rigor that they expect from a GHG audit in the most cost effective way possible.”
The GHG program includes a virtual sample case file and documentation review in order to determine functional area compliance. The GHG audit protocol is modeled after the most recent CMS audit protocols, except that the GHG process provides more time for the organization to prepare. Every audit culminates in a final written report, which provides the organization with findings related to areas of noncompliance as well as a road map for addressing deficiencies.