CMS Audits

Mock Audits: The Intus Care mock audit process will evaluate PACE compliance with regulatoryrequirements in SDAG (Service Determination Requests, Appeals, and Grievances), Provision ofServices, Personal Records, and Compliance and Quality improvement. By working through yourorganization’s current processes, our team will identify what fails to meet CMS’s standards andhow to correct them before audit findings occur.

Audit Preparation: Audit expectations are changing across the board. Our team ensures everyone in your organization is up to date with current expectations and armed with the knowledge to be successful in all audit case scenarios

Audit Remediation and Corrective Action Planning: Following the results of an audit, our team will oversee the corrective action process to address corrective and Immediate corrective action requirement submissions to CMS.

PACE Program Development

Quality Development: Our team provides expertise on all aspects of the quality process from Annual Work Plans to Quality Program Development. We outline plans to improve quality through a data- driven and root-cause-analysis approach and follow quality improvement best practices to develop plans to improve quality outcomes through a data-driven system.

Compliance Development: Our team provides expertise on compliance program development that aligns with PACE program compliance oversight requirements, Part D compliance oversight requirements, and best practices for operating an effective compliance program. We will assist with organizational risk assessments, evaluation of compliance program effectiveness, and corrective actions in response to detected compliance issues.

Utilization Management: Through our data-driven approach we offer programs the ability to see utilization trends and opportunities, methodically advising on how to build lasting processes and improve utilization outcomes.

PACE Program Development

Staff Training & Education: Through our team of PACE experts, we train organizational leadership on processes proven to be successful in the PACE model of care, including but not limited to quality approaches, IDT operations, falls management, and much more.

Data Benchmarking & Reports: Our comprehensive and continuously expanding national database provides custom benchmarking reports identifying outcomes in which your organization is excelling and those that present improvement opportunities in comparison to PACE peers across the country.

New Program Development: We advise on service area expansion applications at the CMS and state levels while structuring frameworks to be successful in the development process.

Operational Growth Management: Whether it’s managing growth, facilitating growth, or advising on the enrollment processes, our team is here to empower your organization to grow successfully.