Medicare Managed Care Manual (Pub. 100-16), Ch. 5 § 30.1.2
Final Audit Reports, Use and Release
30.1.2 - Final Audit Reports, Use and Release
(Rev. 117, Issued: 08-08-14, Effective: 08-08-14, Implementation: 08-08-14)
Following the receipt by the MAO of the Final Audit Report from the NCQA-licensed
audit firm, the MAO must make available a copy of the complete final report to the CMS
ROs as needed. CMS ROs may request the report upon completion or as part of the pre-
site monitoring visit package. In addition, the reports should be available for review
onsite during monitoring visits. CMS will use the Final Audit Reports to support
contract monitoring and quality improvement activities. CMS may use the assessment of
the MAO's administrative and information systems capabilities that are contained in the
audit report and may use the data to conduct post-submission validation. Final Audit
Reports are subject to the Freedom of Information Act (FOIA). CMS will follow the
FOIA requirements regarding any release of such report and will make a determination
about the release of information in each audit report on a case-by-case basis.
Information that both the MAO and CMS deem proprietary will not be released, unless
otherwise required by applicable law.