In November of 2015, CMS announced implementation of a new Independent Audit Validation (IAV) process for any Medicare plan (sponsor) found deficient in a CMS Program Audit. The IAV is designed to test the corrective action plans through universe integrity validation, focused sampling and live demonstrations of processes. HPMS Memo IAV Process
HDC offers an interdisciplinary, expert team to assist in this validation. This team includes CMS SME’s, seasoned auditors, analysts, code reviewers, pharmacists and physicians. HDC works collaboratively with the sponsor and CMS to develop a work plan and timeline. HDC helps to guide the sponsor through each condition testing and the formulation of a result. HDC remains available throughout the year to answer any questions that CMS or a sponsor may have about process and findings.
As defined by CMS, the IA validation process includes: