CMS Program Audit – Independent Auditor (IA) Validation

CMS Program Audit –

Independent Auditor (IA) Validation

Advent offers IA Validation services to Medicare Plans following a CMS Program Audit with audit findings requiring a Corrective Action Plan (CAP). Verify that all issues found during a CMS program audit have been corrected. CMS Medicare Part C and Part D Data Validation performed by Advent do not present a conflict of interest with performing IA Validation.

If your organization’s Medicare Advantage or Prescription Drug Plan has received a corrective action request from the Centers for Medicare and Medicaid Services (CMS), you are now required to hire a certified internal auditor to independently validate the outcomes of your Corrective Action Plan

Advent Advisory Group has the expertise to evaluate your corrections and compliance with the CMS requirement in all areas under the scope of the program audit. This includes enrollment, pharmacy benefit manager operations and management, grievances, coverage determinations, appeals, claims processing and contract compliance.


Advent’s Independent Auditor (IA) Validation team will:


  • Review the CMS findings on areas of deficiencies
  • Coordinate with CMS on developing an approved work plan and validation approach
  • Review a records sample for each area of deficiency to ensure compliance
  • Provide a validation report to CMS



Request a Proposal or

Price Quote

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Why you should choose Advent to validate your
Corrective Action Plan

Advent is a recognized industry leader in performing Medicare compliance and CMS Program Audits nationwide, and fully meets CMS requirements for IA Validation firms.


  • Our IA Validation team has extensive subject matter expertise in Medicare Part C and D as well as compliance reviews.
  • We have been conducting Medicare Data Validation reviews since CMS first required audited data in this area in 2011.
  • We have audited thousands of measure submissions for Medicare Advantage Organizations, Prescription Drug Plans, Employer Group Part D Plans and Medicare-Medicaid Plans nationwide.
  • We are an NCQA-licensed Compliance Audit Organization, which attests to our data validation experience. In addition, we have a firm commitment to audit best practices and a strict adherence to the highest standards of professional responsibility, codes of conduct, organizational independence, data security, and privacy.


At Advent, we’ve built our business by anticipating client needs and delivering customized audit solutions to meet emerging reporting challenges. If deficiencies were found in your full or partial program audit and an Independent Validation Audit is required, contact Advent Advisory Group through the “request a proposal” box above or contact 877.237.0190.


Our Approach

Advent Compliance Audit Reports

Upon completion of the IA Validation, Advent will provide a compliance audit report to the organization outlining the findings of the review and verifying that all issues identified during the CMS program audit have been corrected. This report will include a detailed review of the records sample for each area of deficiency, ensuring that the organization is in compliance with all CMS requirements.


The compliance audit report will serve as evidence to CMS that the organization has fully addressed any deficiencies identified during the program audit and has taken the necessary steps to ensure ongoing compliance with CMS regulations. The report will be issued by a certified internal auditor, who has the necessary training and expertise to conduct a thorough and accurate review of the organization's compliance efforts.


It is important for organizations to carefully review the compliance audit report and address any remaining issues identified by the IA Validation team. Failing to address these issues may result in further CMS actions, including financial penalties or termination from the Medicare program. By working with Advent to ensure the accuracy and completeness of the compliance audit report, organizations can protect their reputation and financial stability while also meeting their obligations to CMS and the Medicare program.


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