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CMS program audit readiness playbook

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CMS 2021 Audit Protocol

General Changes

  • Who made the request
    • Column options change from B/BR to E/ER
  • Approvals, denials and dismissals combined into a single table (except Grievance tables)
  • Open and untimely cases are no longer included
    • Cases are included based on Date of Determination
  • Withdrawn requests/appeals/grievances are excluded
  • “None” replaces “NA” or “N/A” › TMP will be limited to Part C data

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