Prior Authorization Metrics and Your ODAG Universes: Are They Telling the Same Story?
By March 31, 2026, Medicare Advantage organizations were required to post their first public prior authorization metrics: approval and denial
Universe Management
How to Build, Scrub and Clear ODAG and CDAG Universes Before Submission
Universes are not supporting documentation. They are the population a CMS program audit samples from — which is why a
How to Standardize Delegate Data Submissions for CMS Program AuditsÂ
For health plans, CMS audits do not begin with documentation. They begin with data. To ensure accuracy, it’s often beneficial
Automating CMS Compliant Audit Universes: A Practical Guide for Health Plans
Every health plan faces CMS audits as a regulatory requirement, not a surprise event. Yet, for many, preparing CMS compliant
How to Standardize Delegate Data Submissions for CMS AuditsÂ
Delegate oversight is a critical component of CMS audit compliance, yet challenges with inconsistent or delayed Universe file submissions often
Streamline Your Parts C and D Reporting with Universe ScrubberÂ
Medicare Advantage Organizations (MAOs) and Prescription Drug Plan (PDP) sponsors have to submit Parts C and D reports to the
CMS 2022 Protocols for MMP SARAG & MMP CDAG Universe Submission
It is that time again! CMS Program Audits are imminent and the protocols have officially changed for 2022. This blog
CMS Program Audit Universes as a Tool for Ongoing Compliance Monitoring
Updated October 2026: this post describes universe requirements as of 2020. For current requirements, see 2026 CMS Program Audit Update: