CMS Program Audit Support

Advent’s team of Medicare experts can ensure ongoing CMS program audit success

Advent Advisory Group provides a suite of services to ensure full compliance with the Centers for Medicare and Medicaid Services’ (CMS) reporting, data validation, audit, and compliance requirements. As an NCQA-licensed audit organization and a CMS-approved Data Validation Contractor (DVC), Advent provides end-to-end support for Medicare plans, from pre-audit universe validation and mock CMS Program Audits to post-audit Independent Auditor Validation. We even offer a year-round Universe Scrubber subscription service to ensure ongoing compliance and vendor oversight.

Mock CMS Program Audits

Advent’s Mock CMS Program Audit process aligns with CMS’s audit protocols, methodology, and program audit timeline, and can be tailored to meet individual client needs. Typically, the Audit Engagement and Universe Submission phase is conducted in the six weeks prior to field work, and the Audit Field Work phase is conducted over a two-week period. However, the audit scope can be customized to include select measures, reduced sample sizes, and/or adjusted timelines.

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Universe Assessment and Integrity Testing

Advent Advisory Group is a recognized leader in helping organizations prepare for a CMS Program Audit with special focus on data integrity and universe submission validation. Advent’s CMS Program Universe Validation services allow for customizable levels of support which include evaluation of the quality, accuracy, and completeness of each program universe. Our automated Universe Scrubber ensures that program universes are valid, accurately extracted, and most importantly, comply with the latest CMS guidance and protocols.

Independent Auditor (IA) Validation

Advent is a recognized industry leader in Medicare data validation and fully meets CMS’s requirements for independent audit organizations. Our team of clinicians, auditors, programmers, and data analysts have the subject matter expertise to evaluate your corrections and demonstrate full remediation of all conditions cited by CMS. 


Our independent audit validation team will: 

  • Review the CMS program audit report and identify areas requiring a corrective action plan (CAP) 
  • Coordinate with Sponsoring Organization and CMS on developing an approved validation audit work plan including detailed methodology and timelines 
  • Use standard testing procedures that ensure the integrity and completeness of universes submitted, including timeliness testing as appropriate 
  • Target samples related to the original root cause(s) of noncompliance 
  • Provide a validation audit report to CMS demonstrating that the CAP achieved its intended result and remediation is complete 

Medicare Vendor Oversight

Advent’s vendor oversight program provides Medicare plans with the tools, resources, and support needed to ensure ongoing oversight and compliance of first-tier, downstream, and related (FDR) entities that provide health and/or administrative services. Our solutions focus on mitigating downstream issues that can adversely impact HEDIS rates, Medicare Part C and Part D reporting, Centers for Medicare and Medicaid Services (CMS) Program Audit universe submissions, and Medicare Stars Ratings. Packages are customized to meet client-specific needs and can include our online, self-service Universe Scrubber subscription option for clients looking to validate their vendor data directly.