Lessons Learned, Best Practices, and Key Takeaways for 2017
2016 proved to be another big year for the Centers for Medicare and Medicaid Services (CMS) audit and enforcement
activity. Key developments included the full roll-out of the Independent Validation Audit process and some of the most wide-sweeping
enforcement actions cutting across all key risk areas.
Guidehouse has been a trusted advisor to plans in performing “mock” CMS Audits, Independent Validation Audits and ongoing
remediation efforts. It is out of those efforts that we offer key lessons learned, best practices, and key takeaways as health plans
and their FDRs gear up for another strong year of CMS audit and enforcement activity.