Why Monitoring Delegated Entities and Vendors on a Single Platform Is Becoming a Compliance Imperative
A health plan’s regulated work often reaches well beyond its own walls. A pharmacy benefit manager (PBM) processes Part D
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2024 CMS Program Audit Updates: Summary and Insights
Updated October 2026: this post describes the CMS program audit protocols as of 2024. For current requirements, see 2026 CMS
Discover what’s new for Program Audit ODAG Protocol in 2022
The Centers for Medicare & Medicaid Services (CMS) launched a new cycle of CMS program audits in February 2022. Even
Monitor Improper Payments for Part C and Part D with Medicare Audit and Monitoring Software
The monthly premium for Medicare Part B rose 14.5%, from $148.50 in 2021 to $170.00 in 2022, which is partly
FDR Oversight – Turning Policy & Procedure into Practice
Health plans (collectively, “plan sponsors”) that contract with the Centers for Medicare & Medicaid Services (CMS) to provide health services