Medicare Audits & Consulting
We offer a variety of Medicare Audits & Consulting services — click to quickly navigate to each area:
Part C & D Data Validation (DVA)
Are you ready for a seamless Medicare Data Validation Audit? Attest has been conducting data validation projects since 1997 and Medicare DVA projects since their inception in 2011. In 2025, Attest audited more than 25% of the total contracts nationwide.
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Our large and diverse market share has enabled us to continually refine our internal processes and tools to reflect best practices. As such, our reputation of excellence and client satisfaction is reflected in our client growth and retention.
We have never missed a reporting deadline. In 2025, we marked all contracts final in advance of the CMS deadline. We assure client agreement with the Data Validation results via ongoing tracking and plan review of draft findings prior to submission to CMS.
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A core audit team is assigned to each audit. The core team coordinates the efforts of all resources and serves as the primary liaison with your company year-round. Additional resources for source code review and census/sample validation assist the core audit team as needed throughout the project. Access to greater staff expertise allows for efficient completion of documentation review and responses to your communications throughout the year.
We are committed to involving clients throughout the process and keeping them informed of any possible findings. We will share a regular issue log, timeline, and status of key deliverables beginning in April of the audit year. We believe in a no surprises approach, meaning that you will know the status of your DVA throughout the entire process. Here at Attest, we are committed to conducting your Data Validation Audit review in an open, efficient, and reassuring manner.
Independent Auditor Validation (IAV)
Has your organization recently undergone a CMS Program Audit? Our IA Validation services are second to none! We will be with you every step of the way to ensure that your Program Audit Validation and Close Out fully meet CMS’s expectations.
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So you just had a CMS program audit and deficiencies were found which require corrective action. CMS requires the Sponsoring Organization to hire an independent auditor to demonstrate that any noncompliance has been corrected.
That’s where we come in! Attest offers IAV services to Medicare Advantage and Prescription Drug Plans to validate that any issues identified during a CMS program audit have been rectified.
We have been conducting the IAV since 2018 for Sponsoring Organizations of all sizes and have developed an internal tool to help us help you complete the validation expeditiously. Through our diverse audit teams and client base, we have an unmatched level of experience reviewing and understanding Medicare Part C and Part D reporting, compliance reviews, vendors, and transaction systems.
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We will work with you to develop a work plan and timeline that meets health plan and CMS expectations. Because each validation will be unique based on your program audit results, we will work together to identify and define all tasks and timeframes.
After CMS work plan approval, Attest will execute the plan through universe integrity testing, timeliness tests, and targeted sample reviews. We then provide a validation report based on our review findings.
Descriptions of the process may be found in the CMS Routine Program Audit Process Overview in the Phase IV: Audit Validation and Close Out section.
Medicare Data Validation Audits (DVA) performed by Attest do not present a conflict of interest to performing IAV work.
Compliance Program Effectiveness (CPE) Audit
All Medicare Advantage and Part D plans should have an independent, objective review of their compliance program annually. We will work with you to identify risk areas, educate you on CMS audit protocols, and provide meaningful feedback based on our assessment.
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As part of the CMS Compliance Program requirements, Part C and D Sponsors should be conducting a Compliance Program Effectiveness (CPE) audit annually. This may be done internally or by a third party. You’re probably thinking this reminds you of the CPE program area of the CMS Program Audit. It’s very much the same!
Here at Attest we partner with you as the third party who takes a look under the hood of your Compliance Program. Engaging in this audit with us allows you to check the box on the annual CMS requirement while also being prepared for the CPE portion of the program audit. Since we have participated in many Medicare Independent Auditor Validations, we are familiar with the Program Audit protocols and what details CMS may hone in on in your CPE program area.
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An audit team is assigned to each audit and a kick off call is scheduled. We utilize the CMS Audit Submission checklist to get us going with the documentation. Our approach includes following the CPE protocols and program audit process, while also giving you the opportunity to provide input on what compliance oversight activities we select for tracer summaries. Was there a department frequently put on a CAP that you’re concerned about? Or a process that repeatedly caused members to lose access to a benefit? We will take your input into account as we review the compliance oversight activities universe and make our selections for tracer case presentations.
We will share a regular issue log, timeline, and status of key deliverables throughout the audit. We believe in a no surprises approach, meaning that you will know the status of your audit throughout the entire process. In fact, we have found it to be helpful to our clients to provide feedback directly after each tracer case presentation and interview. We are committed to conducting your review in an open, efficient, and reassuring manner. A Final Report will be provided that includes our observations and recommendations from each tracer case presentation, interviews and documentation. Because of our transparency and collaborative approach, anything that appears on the final report will have already been discussed!
Mock Medicare Program Audit
Are your prepared for a CMS Program Audit? We will work closely with you to walk you through the CMS Program Audit process, including Universe Integrity Testing, Sample Selection and Review, UM Assessments, and much more!
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Did your organization complete a CMS program audit which resulted in quite a bit of deficiencies requiring corrective action? Was there a particular program area that you’re worried about for future program audits? Do you want to make sure that your next program audit is a breeze? Engage with us in a mock program audit! We can perform a mock audit on all program areas or tailor it to a selection of program areas to meet your needs.
Attest has been conducting data validation projects since 1997 and Medicare DVA projects since their inception in 2011. We also conduct the Independent Auditor Validation and Compliance Program Effectiveness audits. This has us well positioned to partner with you on a Mock Program Audit to keep you on your toes!
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We will utilize the CMS program audit protocols to work through the mock audit. An audit team will be assigned to you, and they will schedule a kick off call to discuss timeline, deliverables, answer your questions and ensure everyone is set up for a successful mock program audit. We will then begin reviewing your submitted data and documentation and prepare for the interviews where your team can answer any questions from Attest.
Attest is committed to involving clients throughout the process and keeping them informed of any possible findings. Attest shares a regular issue log, timeline, and status of key deliverables throughout the course of the audit. We believe in a no surprises approach, meaning that you will know the status of your mock program audit throughout the entire process. Attest remains committed to conducting your audit review in an open, efficient, and reassuring manner.
Ready to get started?
We’re here to help. Tell us about your needs, and we’ll discuss solutions we can offer your organization.
