Compliance Auditing and Monitoring


Helaine Fingold, Senior Counsel, and Lynn Shapiro Snyder, Senior Member of the Firm, will be joined by Judith P. Nelson, Director, Medicare Advantage Strategy, DST Health Solutions, to present "Compliance Auditing and Monitoring," a webinar hosted by Health Plan Alliance MAC.  

The upcoming webinar will discuss managing key CMS compliance concerns as well as operational approaches for ensuring management accountability. Plan sponsors must use a solid business model along with a strong management approach which incorporates compliance reporting and oversight in order to effectively operate its Medicare Advantage plan. While reporting and oversight are key to ensuring regulatory compliance, they are also important in assessing effective and efficient operations. 

Presenters will specifically address: 

  • What is the difference between auditing and monitoring, and how do these help inform operations? 
  • How should plans use internal reporting to ensure regulatory compliance and operational effectiveness?
  • What are the roles of compliance staff and operational staff in managing plan policies and operations? 
  • What are CMS’s key compliance concerns?
  • How can plans address these concerns from an operational perspective and as a basis for prioritizing their compliance functions?
  • How can plans oversee vendors to best ensure regulatory compliance and operational effectiveness?