🚨Big Changes Coming to CMS Program Audits in 2026 — What You Need to Know

Our Products

Comprehensive compliance automation tools designed to transform every aspect of healthcare operations

Risk Assessment

Conduct formal risk assessments that meet CMS and regulatory requirements. Proactively address compliance risks.

Entire Risk Lifecycle
From identification to mitigation and monitoring
CMS Requirements Built-in
Aligned with regulatory standards
Risk Scoring Matrix
Automated risk prioritization
Mitigation Tracking
Monitor corrective actions to completion
Identify
Risks proactively
Track
Mitigation efforts
Meet
CMS requirements
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Risk Matrix

Impact →
Low
Medium
High
High
2
5
Med
3
4
Low
8
Critical: Data Breach Risk9.2
High: Audit Non-Compliance7.5
Low: Documentation Gaps3.1

Compliance Work Plan

Translates CPE findings into ongoing monitoring tasks. Ensures corrective actions are completed and evidenced.

CPE Finding Translation
Convert audit findings into actionable tasks
Automated Workflows
Streamline task assignment and tracking
Evidence Management
Centralized documentation repository
Progress Dashboards
Real-time visibility into compliance status
Close
Audit findings faster
Automate
Task management
Prove
Compliance efforts
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CPE Work Plan

Q3 2025
CPE Finding: Network AdequacyHigh Priority
Update provider directoryCompleted
Conduct geo-access analysisCompleted
Submit corrective action planIn Progress
CMS validation reviewPending
50% CompleteDue: Sep 15
CPE Finding: Member CommunicationsMedium
8
Tasks
3
Complete
21
Days Left
15 Active Work Plans
73% On Track

Incident Management System

Manages Compliance, Privacy, and Fraud incidents. Includes breach assessment and ensures HIPAA compliance.

FWA Detection
Fraud, Waste, and Abuse tracking
Breach Assessment
HIPAA-compliant breach evaluation
Investigation Workflows
Structured incident resolution
Regulatory Reporting
Automated compliance notifications
Respond
To incidents faster
Document
Every action
Ensure
HIPAA compliance
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Active Incidents

3 Critical
INC-2025-001
Potential HIPAA Breach
Privacy2 hours ago
Status
Investigating
INC-2025-002
FWA Alert: Unusual Billing
Fraud1 day ago
Status
In Review
12
This Month
8
Resolved
4
Pending

Guidance Distribution System

Distributes regulatory guidance and collects acknowledgments. Ensures updates reach the right personnel.

CMS Memo Tracking
Stay current with regulatory updates
HPMS Notices
Automated distribution of critical notices
Implementation Proof
Document compliance with new requirements
Acknowledgment Tracking
Ensure staff awareness and compliance
Distribute
Updates instantly
Track
Acknowledgments
Prove
Implementation
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Latest CMS Guidance

HPMS Memo: 2025 Part C Updates
Published 2 days ago
142/150 Acknowledged
95% Complete
!
Urgent: Model of Care Deadline
Action required by Aug 30
45/150 Acknowledged
30% Complete
Distribution Stats
23
Memos This Month
87%
Avg. Acknowledgment
FEATURED

CMS Universe Scrubber

Automates validation of CDAG, ODAG, FA, SNPCC files. Ensures your data is CMS-ready and reduces risk of audit findings.

500+ Validation Rules
Comprehensive checks aligned with CMS specifications
Row-by-Row Validation
Detailed analysis of every data point
Instant Evidence Packages
Audit-ready documentation in seconds
Prevent $25,000+ Violations
Catch errors before CMS does
Save
Hours of manual review
Prevent
Costly violations
Ensure
100% CMS compliance
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CMS File Validation

Processing
ODAG_H5521_2025.csv2.3 MB
✓ 12,456
Valid Rows
✗ 23
Errors
âš  156
Warnings
Row 1,234: Invalid Contract ID
Missing required field
!
Row 456: Date Format
Should be MM/DD/YYYY

Policies & Procedures

Facilitates policy review with task-based assignments. Provides comprehensive revision tracking.

Task-Based Assignments
Structured policy review process
Revision Tracking
Complete version control and history
User Accountability
Track who reviewed and approved
Automated Reminders
Never miss a review deadline
Maintain
Current policies
Track
All revisions
Ensure
Accountability
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Policy Review Status

HIPAA Privacy Policy
v3.2 • Next review: Oct 2025
Current
Code of Conduct
v2.8 • Next review: Aug 2025
Review
FWA Prevention
v1.9 • Next review: Sep 2025
Update
5 policies require review this quarter

Ready to Transform Your Compliance?

See how our integrated suite of products can save you time, reduce risk, and empower your team.

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