Tips for a Better CMS Program Audit Experience
CMS recently published its annual Part C and Part D Program Audit and Enforcement Report. The report provided recommendations and guidance for Sponsors to consider when preparing for future CMS Program Audits.
Key tips include:
1: Undergo a Mock CMS Program Audit — Identify vulnerabilities, spot noncompliance, and prepare staff.
2: Validate Data Universes — Ensure submissions are accurate, complete, and compliant with CMS record layouts.
3: Ensure Access to HPMS — Verify contact info, confirm staff access, and prepare to use the HPMS audit module for data transfers.
4: Confirm Technology Readiness — Test Microsoft Teams access, screen-sharing, and delegate readiness in advance.
5: Establish a Quality Review Process — Use checklists and automated tools to ensure documentation and data accuracy.
These recommendations aim to streamline the audit process, reduce compliance risks, and improve sponsor performance.
Stay Audit-Ready with Advent
Preparing for a CMS Program Audit doesn’t have to be overwhelming. At Advent Advisory Group, we help health plans turn CMS guidance into actionable strategies that reduce risk and build confidence.
Our experts partner with your team to deliver:
✅ CMS Program Audit Universe Assessments
✅ Mock Audit Review Services
✅ Expert Compliance Consulting
✅ Independent Auditor Validation Support
With Advent, you can move from audit anxiety to proactive assurance — ensuring your plan is ready, compliant, and confident when CMS comes calling.
Advent Advisory Group Insights
