Medicare Managed Care Manual (Pub. 100-16), Ch. 5 § 30.1.2

Final Audit Reports, Use and Release

Last amended: 2014Year: 2014Length: 186 wordsOfficial source
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.
Medicare Managed Care Manual (Pub. 100-16), Ch. 5 § 30.1.2: Final Audit Reports, Use and Release | Justis AI