Medicare Financial Management Manual (Pub. 100-06), Ch. 7 § 20.1.1
Risk Analysis Chart
20.1.1- Risk Analysis Chart
(Rev. 308, Issued: 10-26-18 Effective: 09- 01- 18, Implementation: 11-27-18)
Table 1 - This chart is provided to assist contractors in selecting the high-risk activities within
their organization. There are 3 columns that gives directions on how to rank operational areas for
potential risk.
HIGH RISK FACTORS
(1)
MEDIUM RISK FACTORS
(2)
LOW RISK FACTORS
(3)
• Recent review or audit findings
showing material weaknesses
related to internal control
processes.
• Areas affected by significant
changes in laws, regulations,
special requirements or
instructions.
• Areas where policies and
procedures regarding internal
control over financial reporting
are not well documented.
• Areas of significant financial
vulnerabilities (e. g., new
accounting or regulatory
guidelines).
• Areas where guidelines have
varied interpretations and/or
areas being restructured.
• Areas with new contract
activities.
• Areas where objectives of the
corporate mission could be in
jeopardy if not properly
implemented.
• Areas lacking performance
measures or monitoring.
• Potential program
weaknesses related to
violation of privacy issues.
• Areas with high visibility.
• Areas where due dates are
often not met or responses to
correspondence are late.
• Areas with consistent
complaints or inquiry.
• Areas where there are no
written policies and
procedures.
• Areas where recent policy
changes were implemented.
• Areas with reorganization
activities.
• Areas where there is a
breakdown in communication
with corporate, regional, state
or satellite offices, etc.
• Areas with new or
problematic performance
measures.
• Areas where CAPs have
already been
implemented.
• Areas with low visibility;
routine program
operations.
• Areas where workers are
meeting routine program
operations and
performance targets and
attitudes and staff
motivations are high.
• Areas that undergo
frequent financial audits/
reviews by external
parties (e.g., CFO, SSAE
18, A-123 Appendix A,
CPIC, etc.).
• Areas that managers
perform periodic reviews
to ensure that work
assignments are
performed consistently,
and accurately.
• Work activities are being
phased out.
• Areas with established
and validated
performance measures.
Scoring Criteria Guidelines:
Level
Level Description
High:
If an activity has two or more high risk rating factors, review annually.
Medium: If an activity has two or more medium risk factors, review biannually.
Low:
Low activities can be reviewed within a five (5)-year timeframe or at manager’s
discretion that should be balanced with costs and resources.
End Section 20.1.1 – Risk Analysis Chart: Back to Table of Contents