Conformity with CMS compliance guidance requires highly efficient communication and effective collaboration between a number of operative departments throughout a health plan.
Marketing communications, compliance, IT, operations and medical management will need to coordinate their functional activities and reporting in order to comply with CMS standards. An effective process workflow that keeps everything running smoothly, on-time and in compliance is critical.
Health plan member communications directors have the tough job of guiding collateral through a creation cycle that includes tracking multiple versions, pushing through numerous bottlenecks, dealing with multiple subject matter experts, ensuring regulatory compliance and setting up printing and delivery. An effective project management tool specifically designed for health plans can make things infinitely simpler and ensure materials are in compliance with CMS. This will also enable easier reporting when CMS audits are required.
A robust risk management function will be essential for Medicare Advantage plans required to detect, mitigate and alleviate risk throughout an organization. An organization's risk management tool is key to compliance management as federal and state guidance evolves at a brisk pace.
Tonya Teschendorf is the director of compliance at Cody Consulting.