Stephen Altenburger, PharmD

For Medicare plans, the 2015/2016 program audit protocol updates address many of the issues and questions raised with the previous protocols, but may result in additional challenges.

The 2015 Medicare Part D audit protocols add a layer of complexity to Part D plans and increase their probability of receiving mandatory corrective actions.

Recent guidance and proposed rules for the Medicare hospice program will have a profound impact on plans providing Medicare Part D services.

The 2014 CMS Coverage Determination and Appeals audit will challenge plans providing Medicare Part D services, and could lead to a cascading impact much larger than audit failure alone.