CMS Program Audit Preparation – 

Ready or Not!

By Shelley Segal, CEO


Audit Ready?
2023 CMS Program Audits Are Here!

Sponsors (Medicare Advantage and Part D Organizations) are encouraged to perform mock CMS Program Audits, especially generating universes. Mock CMS Program Audits will help you prepare for an actual CMS Program Audit, and may improve your operations by identifying areas that are problematic or that may have negative member impact. Audits are not just about compliance. Correct Identification of member grievances and inquiries are crucial; when were the latest grievance samples audited? What were the results? When did the member receive a written response? Who was informed of the audit results?

Become Familiar with The Most Current CMS Program Audit Protocols

CMS states that it is essential to use the most current CMS audit protocols. Is your 2023 CMS audit work plan ready? Do not wait! CMS will issue more audit engagement letters within the next few months. Within 2 business days of the date of the engagement letter, CMS conducts a follow-up call with the Sponsoring organization; so, are your questions ready? This is first impression time! And it is the best time to get your complete organization engaged.

Best Practices

Engage an expert professional team to conduct your required annual CPE audit or to conduct a mock CMS Program Audit. Segal Medicare Experts (SME) will help you prepare documents in advance to avoid a last-minute fire drill after you receive your CMS engagement letter. Call SME today for a quote and to schedule the SME team for anything you need.

SME is here to help! We can complete your required annual CPE audit
or a mock CMS Program Audit NOW!


Select the “easy” button!      Call us:

Segal Medicare Experts or 562.498.2218


·         42 C.F.R. §§ 422.503(b)(4)(vi)(F), 423.504(b)(4)(vi)(F)

·         Chapter 21 (Part C) and Chapter 9 (Part D), Section 50.6.5 – Audit of the Sponsor’s Operations and Compliance Program