CMS Will Be Stepping Up Their Audit Efforts

CMS Will Be Stepping Up Their Audit Efforts

CMS Will Be Stepping Up Their Audit Efforts

In a recent report by the U.S. Department of Health and Human Services (HHS), it was revealed that even the Centers of Medicare & Medicaid Services (CMS) is held accountable for performing audits and following recommendations in accordance with Federal requirements. While CMS did make significant progress in the timely resolution of audit recommendation, the report mentioned that CMS did not always resolve audit recommendations in a timely manner. This particular report addressed fiscal years 2015 and 2018.

The report mentioned that CMS resolved 1,231 of the 1,371 recommendations that were outstanding; however, they did not resolve over 32 percent within the resolution period. In addition, 140 audit recommendations that were past due were not resolved.

The report revealed that CMS did have policies and procedures in place to ensure that audit recommendations were resolved in compliance with Federal requirements. These audits ensure that recipients of Federal awards have complied with applicable Federal requirements related to management and use of funds.

Hints for Healthcare Organizations

This report offers us some important hints for healthcare organizations, first instance the importance of having auditing and monitoring policies and procedures in place. Any discrepancies should be handled in a timely manner. By not having an effective auditing and monitoring program in place and handling recommendations or discrepancies in a timely manner, healthcare organizations (including CMS) run the risk of noncompliance with Federal requirements and mismanagement of funds. While the Office of Inspector General (OIG) is recommending that CMS follows its policies and procedures and essentially, step up their audit efforts, we think it is an important hint for all healthcare organizations to do the same.

CMS did concur with the OIG's recommendations and will continue to assess and further refine its audit resolution process to ensure that recommendations are resolved within the required period.

Did you know Healthcare Compliance Pros can help you with your audit efforts? Contact us by phone at 855-427-0427 or by email [email protected] for more information.