CMS’s Proposed 2027 Medicare Advantage Program Audit Protocols: What Compliance Officers Need to Know
On July 6, 2026, CMS published a Federal Register notice (document 2026-13603) seeking OMB approval for a revised information collection […]
Audit Readiness
Continuous Internal Audit for MA Plans: What Year-Round Readiness Actually Requires
CMS no longer audits in seasons. With compliance now embedded in every program area and reviews running year-round, audit readiness
The 5 pillars of a continuous audit readiness framework for health plans
A continuous audit readiness framework is not a technology purchase, a new team structure, or an expanded budget. It is
Mock audits for health plans: why once a year is not enough
A mock audit for a health plan should work as a diagnostic tool — not a final exam. Yet in
Why CMS program audit readiness breaks — even when your team is good
CMS program audit readiness fails in most health plans for the same structural reason. It is not built as an
Why CMS audits are designed to test operations, not just documentation
For years, health plans treated CMS audits as documentation exercises. If policies looked current, files appeared complete, and evidence arrived
2026 CMS Program Audit Update: What Plans Must Do To Align
What Changed for 2026: Key Updates from CMS The 2026 audit update from CMS brings a fundamental shift in audit
2026 CMS Program Audit Countdown: How Health Plans Can Prepare Now
The audit clock has already started CMS Program Audits follow predictable patterns, but most health plans still treat them as
Internal Audit: Why Health Plans Can’t Rely on Generic Internal Audit Tools
Why most internal audit tools don’t work as expected for health plans Every year, CMS program audits trigger millions in
The 2025–2026 CMS Program Audit Calendar for Health Plans: Key Deadlines and How to Prepare
The CMS Program Audit Calendar for Health Plans is more than a timeline; it’s a test of preparedness. CMS Program