CMS Program Audit Results
Guidance for information regarding Part C and Part D program audit results. Program audits evaluate sponsors’ compliance with a number of core program requirements, key among those are the sponsors’ ability to provide beneficiaries with access to medically necessary services and prescription drugs.
Final
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: September 09, 2020
This website contains information regarding Part C and Part D program audit results. Program audits evaluate sponsors’ compliance with a number of core program requirements, key among those are the sponsors’ ability to provide beneficiaries with access to medically necessary services and prescription drugs.
The chart below provides detail on the number of audit elements tested during each audit, the number of Corrective Actions Required (CARs) and Immediate Corrective Actions Required (ICARs), the audit year, and whether an enforcement action was taken as a result of the audit.
In addition to the information provided in the table below, please refer to the Part C and Part D Program Audit and Enforcement Reports for a graphical representation of the overall and individual program area audit scores of more recently audited sponsors. These reports can be found in the Downloads section of the Program Audits page.
For questions on any of this information, please send an email to part_c_part_d_audit@cms.hhs.gov.
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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.