Prepare for Your 2023 CMS CPE Audit Now!!! R U Ready?!

By Shelley Segal, CEO


It’s never too early to prepare your organization for a Centers for Medicare and Medicaid Services (CMS) Compliance Program Effectiveness (CPE) Audit. Fear not! Segal Medicare Experts (SME) is here to help; especially if you have NOT had a CMS Program Audit in the last three years!!! Is your organization ready? The CMS Audit requires the complete organization to have a successful audit!!! “Always Be Prepared”

Within the CPE Program Audit, CMS will be assessing 3 areas:

Prevention Controls and Activities – Processes, metrics, and oversight activities in place to identify a trend towards noncompliance, as well as intervention taken to correct and/or mitigate.

Detection Controls and Activities – Processes, metrics, and oversight activities to internally identify noncompliance in a timely manner.

Correction Controls and Activities – Processes to quickly respond to noncompliance, including root cause analysis, impact assessment, communication, and corrective action.

There are several ways CMS assesses these controls and activities, as well as elements of a Sponsoring Organization’s (SO’s, also known as Health Plans) compliance program. Through a combination of documents, questionnaires, overview presentations, work plans, organizational charts, risk assessments, data universes, reporting, and interviews, CMS will gain a comprehensive understanding of the effectiveness of your compliance program.

Prepare by engaging Segal Medicare Experts to assist in focused mock audits. SME helps numerous Health Plans prepare for CPE audits and knows the key to getting the best outcome.

Segal Medicare Experts

•    Includes the types of documentation CMS expects;

•    Shows how to effectively compile questionnaires; and,

•    Provides interview preparation tools and sessions.

If you have questions and/or want a FREE CPE Audit quote, please contact us: 

Select the “easy” button!      Call us:

Segal Medicare Experts or 562.498.2218