Medicare-Medicaid Plan (MMP) Audit Programs
| SPOTLIGHT & RELEASES |
CMS conducts program audits of MMPs, Medicare Advantage Organizations, and Prescription Drug Plans, collectively referred to as "sponsors". CMS Medicare Advantage Parts C and D program audits for sponsors that include and MMP utilize the Center for Medicare Program Audit Protocols as well as two MMP-specific protocols designed to ensure compliance with three-way contract requirements in the following areas:
- MMP Care Coordination & Quality Improvement Program Effectiveness (MMP-CCQIPE) Program Area
- MMP Service Authorization Requests, Appeals and Grievances (SARAG) Program Area
More information on audit programs is available below:
- CY 2018 MMP Audit Protocols Memo (12/21/2017) (PDF)
- MMP Care Coordination & CCQIPE Program Audit Process (12/2017 (PDF))
- MMP SARAG Program Audit Process (12/2017) (PDF)
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Page Last Modified:
11/07/2019 04:11 PM