Delegation Oversight

CMS audit practices may have undergone a few changes in recent years, but the core motivation remains the same; beneficiary protection. Our compliance experts can help minimize risk and maximize resources by performing a gap analysis and a comprehensive Part C and D audit.

Annual Risk Assessment

The annual risk assessment is an essential part of a broader risk management strategy that continually assigns priorities for mitigation plans. GHG can also help with the required annual audit and monitoring program to ensure that your crucial day-to-day compliance initiatives are not disrupted.

Health Policy Consulting

GHG delivers best-in-class health policy consulting services to our clients and their partners operating in Medicare, Medicaid, and the Health Insurance Marketplace. Using robust research and analytic methodologies, we can help you strengthen your health programs and make informed policy decisions.

Application Support

The application process for MA and Part D, the Health Insurance Marketplace, and ACOs is an demanding one. Completing the application requires cooperation from your entire organization, and leaves little room for error. Our experts will assist you through every step of the application process from gathering data, completing and submitting the application, and responding to CMS’ follow-up questions.

Part D / Pharmacy

With our professional services and unmatched compliance tools, GHG can help your MA Part D or Prescription Drug Plan implement efficient and compliant internal operations while effectively preparing for CMS audits. Our broad array of services can also assist you with post-audit remediation and the implementation of best practices.

Remediation

Through an internal auditing process, the need for improvements may have been identified and corrective actions may have been implemented. GHG can determine whether the appropriate measures have been put in place to monitor and audit these items going forward to ensure sustainable correction. Our remediation services can also help you anticipate any potential deficiencies that CMS may identify during audit.

Interim Management

GHG’s seasoned veterans can enrich your team by providing the leadership and knowledge your organization needs to keep moving forward. If it’s just a question of bandwidth, we can supplement your department(s) with professionals who have years of experience in providing strategic, operational, financial, and clinical services across a full spectrum of business needs.

Marketing Material Review

Marketing departments can often feel as though they’re at a disadvantage with the shortened period between bid submission and the start of the Annual Enrollment Period. GHG can develop or review your sales and marketing collateral by product type to help ensure your high-impact messaging is both targeted and compliant.

Audits

In today’s regulatory environment, it’s critical that your PBM and other delegated entities perform flawlessly. With GHG’s in-depth delegation oversight assessments, our experts can help your organization learn how to identify potential issues and address risk – empowering your teams to ask the tough questions.