Program Audits

Documents and forms in this information collection

Document Name	Document Type
Form CMS-10717 Pre Audit Issue Summary Program Audits	Form
Form CMS-10717 Compliance Program Effectiveness (CPE) Compliance Oversight Questionnaire Program Audits	Form and Instruction
Form CMS-10717 Compliance Program Effectiveness (CPE) Customized Organizational Structure and Governance PowerPoint Presentation Program Audits	Form and Instruction
Form CMS-10717 Part D Formulary and Benefit Administration (FA) Supplemental Questionnaire Program Audits	Form and Instruction
Form CMS-10717 Special Needs Plans - Care Coordination Supplemental Questionnaire Program Audits	Form and Instruction
Form CMS-10717 Part D Coverage Determinations, Appeals, and Grievances (CDAG) Processing of Coverage Requests Root Cause Analysis and Impact Analysis Program Audits	Form and Instruction
Form CMS-10717 Part D Coverage Determinations, Appeals, and Grievances (CDAG) Classification of Requests Root Cause Analysis and Impact Analysis Program Audits	Form and Instruction
Form CMS-10717 Special Needs Plans Care Coordination (SNPCC) Root Cause Analysis and Impact Analysis Program Audits	Form and Instruction
Form CMS-10717 Special Needs Plans Care Coordination (SNPCC) HRA Timeliness Mitigation Analysis (HRA-TMA) Program Audits	Form and Instruction
Form CMS-10717 Part C Organization Determinations, Appeals, and Grievances (ODAG) Processing of Coverage Requests Root Cause Analysis and Impact Analysis Program Audits	Form and Instruction
Form CMS-10717 Part C Organization Determinations, Appeals, and Grievances (ODAG)Classification of Requests Root Cause Analysis and Impact Analysis Program Audits	Form and Instruction
Form CMS-10717 Organization Determinations, Appeals, and Grievances (ODAG) ODAG Timeliness Mitigation Analysis (ODAG-TMA) Program Audits	Form and Instruction
Form CMS-10717 Formulary and Benefits Administration (FA) Root Cause Analysis and Impact Analysis Program Audits	Form and Instruction
Form CMS-10717 Root Cause Analysis Program Audits	Form and Instruction
Form CMS-10717 Independent Validation Audit Work Plan Program Audits	Form and Instruction
Form CMS-10717 Attendance Log for Meetings/Webinars/Conferences Program Audits	Form
Form CMS-10717 CMS Request for Additional Information (RAI)/Sponsor Response Program Audits	Form and Instruction
Form CMS-10717 Independent Validation Auditor (IVA) Validation Report Program Audits	Form and Instruction
CPEProtocol.docx	Instruction
FAProtocol.docx	Instruction
CDAG Protocol.docx	Instruction
ODAGProtocol.docx	Instruction
SNPCCProtocol.docx	Instruction
CMS-10717 Pre Audit Issue Summary PreAuditIssueSummary.docx	Form
CMS-10717 Compliance Program Effectiveness (CPE) Compliance Oversi CPEQuestionnaire.docx	Form and Instruction
CMS-10717 Compliance Program Effectiveness (CPE) Customized Organi CPEPowerPointPresentation.docx	Form and Instruction
CMS-10717 Part D Formulary and Benefit Administration (FA) Supplem FAQuestionnaire.docx	Form and Instruction
CMS-10717 Special Needs Plans - Care Coordination Supplemental Que SNPCCQuestionnaire.docx	Form and Instruction
CMS-10717 Part D Coverage Determinations, Appeals, and Grievances CDAGPCRImpact.xlsx	Form and Instruction
CMS-10717 Part D Coverage Determinations, Appeals, and Grievances CDAGCRImpact.xlsx	Form and Instruction
CMS-10717 Special Needs Plans Care Coordination (SNPCC) Root Cause SNPCCImpact.xlsx	Form and Instruction
CMS-10717 Special Needs Plans Care Coordination (SNPCC) HRA Timeli SNPCC HRATMA.xlsx	Form and Instruction
CMS-10717 Part C Organization Determinations, Appeals, and Grievan ODAGPCRImpact.xlsx	Form and Instruction
CMS-10717 Part C Organization Determinations, Appeals, and Grievan ODAGCRImpact.xlsx	Form and Instruction
CMS-10717 Organization Determinations, Appeals, and Grievances (OD ODAGTimelinessMT.xlsx	Form and Instruction
CMS-10717 Formulary and Benefits Administration (FA) Root Cause An FAEnrolleeImpact.xlsx	Form and Instruction
CMS-10717 Root Cause Analysis RootCauseAnalysisTemplate.xlsx	Form and Instruction
CMS-10717 Independent Validation Audit Work Plan IndependentValidationAWP.docx	Form and Instruction
CMS-10717 Attendance Log for Meetings/Webinars/Conferences AttendanceLogTemplate.docx	Form
CMS-10717 CMS Request for Additional Information (RAI)/Sponsor Res ProgramAuditCMSRAI.docx	Form and Instruction
CMS-10717 Independent Validation Auditor (IVA) Validation Report IndependentValidationART.docx	Form and Instruction
FAProtocol SPM updated 060326 TRACKED.pdf Formulary and Benefit Administration (FA) - Track change version	IC Document
IndependentValidationAWP _TrackChange.pdf Independent Validation Audit Work Plan - Track Change version	IC Document
ODAGProtocol Track Changes Version.pdf Organization Determinations, Appeals, and Grievances - Track Change version	IC Document
SNPCCProtocol Tracked changes.pdf Special Needs Plans Care Coordination - Track change	IC Document
CPEProtocol 5 21-redlined .pdf Part C and Part D Compliance Program Effectiveness - Track change	IC Document
CDAG Protocol Master Track Changes Version.pdf CDAG_Program Audit Protocol - Track Change	IC Document
CDAGPCRImpact_TC.pdf CDAG_Processing of Coverage Requests Root Cause Analysis and Impact Analysi - Track Change	IC Document
CDAGCRImpact_TC.pdf CDAG_Root Cause Analysis and Impact Analysis - Track Change	IC Document
RootCauseAnalysisTemplate_TC.pdf RootCauseAnalysis - Track Change	IC Document
FAEnrolleeImpact Updated 060426 TRACKED.pdf Formulary and Benefits Administration (FA) Root Cause Analysis and Impact Analysis - Track Change	IC Document
ODAGPCRImpact_TC.pdf ODAG_Processing of Coverage Requests Root Cause Analysis and Impact Analysis - Track Change	IC Document
ODAGCRImpact_TC.pdf ODAG_Root Cause Analysis and Impact Analysis - Track Change	IC Document
SNPCC HRATMA Tracked changes.xlsx SNPCC-HRA-TMA - Track Change	IC Document
SNPCCImpact Tracked changes.xlsx SNPCC-Root Cause Analysis and Impact Analysis - Track Change	IC Document

            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.