What Not to Do When CMS Audits You

Compliance Conversations by Healthicity

Let’s say you’re a Medicare Advantage organization and one day you receive a notification from CMS that you’ve been selected for program audit. What should you do? Recently, I sat down with Scott Robinson, director of compliance at Davis Vision, and former medicare contractor who used to accompany the folks at CMS to conduct effectiveness audits. Robinson gave me the details on what to do and what not to do when and if you receive the news. “The first thing is to not panic,” Robinson said, “All you really need to do is explain yourself. You just need to articulate your usual business practices in a way that CMS will understand and agree with.” But doing this requires you to be ready for it. Tune into this episode to learn how to: Prepare for a CMS Audit Before it Happens Stay Calm During a CMS Audit Effectively Explain Yourself to CMS