42 CFR 422.502 describes CMS'
regulatory authority to evaluate, through inspection or other
means, Medicare Advantage Part C organizations. These records
include books, contracts, medical records, patient care
documentation and other records that pertain to any aspect of
services performed, reconciliation of benefit liabilities, and
determination of amounts payable. 42 CFR 423.503 states that CMS
must oversee a Part D plan sponsor's continued compliance with the
requirements for a Part D plan sponsor. 423.514 states that the
Part D plan sponsor must have an effective procedure to develop,
compile, evaluate, and report to CMS, to its enrollees, and to the
general public, at the times and in the manner that CMS requires,
statistics regarding areas such as cost of operations, patterns of
utilization availability, accessibility, and acceptability of
services. CMS developed a strategy to address our oversight and
audit responsibilities within the context of limited
audit/oversight resources. We intend to combine all Part C and Part
D guides into one universal guide as it will promote efficiency and
effectiveness and reduce financial and time burdens for both CMS
and Medicare-contracting entities.
Statute at
Large: 18
Stat. 1857 Name of Statute: null
Statute at Large: 18
Stat. 1860 Name of Statute: null
The decrease in the burden
estimate reflects 1) that CMS is auditing at the parent
organization level, and while multiple contracts under that parent
may be the subject of an audit, there are certain efficiencies
built into auditing an organization once at the parent level. 2)
the increased amount of information that is provided electronically
instead of hard copy, which reduces printing, copying and mailing
costs and time; and 3) the combining of all Part C and D guides
into one universal audit instrument, which reduces duplication and
creates a certain amount of efficiency in the process.
$0
No
No
Uncollected
Uncollected
No
Uncollected
Bonnie Harkless
4107865666
No
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.
Crosswalk.pdf
Medicare Parts C and D Universal Audit Guide