As a licensed National Committee for Quality Assurance (NCQA) organization, MetaStar has a history of successful data projects. All of our audits have been completed within budget and on-time.

MetaStar’s approach to Medicare Part C and D Data Validation Planning and Data Validation Activities offers a low-cost, low-impact method that helps Plan Sponsors understand what they need to do by:

• Providing recommendations on completing the Organizational Assessment Instrument (OAI)
• Reviewing existing documentation via a high-level gap analysis
• Comparing the Sponsoring Organization’s processes against each Medicare Part C and Part D standard to identify gaps in data and policy
• Summarizing findings via a customized report to target the key strengths and weaknesses of the Sponsoring Organization pertaining to the Medicare Part C and Part D Data Validation project
• Offering a series of strategy calls throughout both the data validation planning and the data validation activities
• Providing a three-day onsite visit that includes process clarification and focuses on data validation activities
• Providing project progress updates on data validation activities following the onsite visit
• Submitting preliminary findings to the Sponsoring Organization to provide an opportunity for feedback
• Submitting the Data Validation findings into HPMS

Project Timeline

This timeline encompasses the data validation planning and the data validation activities needed to complete the project by May 31, 2012. 

The Centers for Medicare & Medicaid Services (CMS) requires ongoing monitoring of Medicare Part C and D programs for Medicare Advantage (MA), Medicare Advantage Prescription Drug (MA-PD) and Prescription Drug Benefit (PDP) plans. Part C and D Data Validation requirements became effective in 2010 with the first validation taking place in 2011. Data Validation continues to be required in 2011 for 2012 validation. CMS has increased the 2012 validation from 12 to 17 measures for organizations reporting the full scope.

MetaStar Offers Unparalleled Expertise in Data Validation

• Experienced staff with the strongest combined Part C and D audit and data experience in the industry, specializing in data validation, external quality review organization (EQRO) and HEDIS audits informed by experience in a multitude of federal, state and local projects.
• Independent analysis providing you an unbiased view of your reporting processes.
• Well-established, organized, collaborative methods of data and document collection, assessment and reporting.
• We operate in an environment that is compliant with HIPAA privacy and data security requirements.
• MetaStar has maintained the CMS Quality Improvement Organization (QIO) contract in Wisconsin for more than 35 years and the Utilization Review and EQRO contracts of the Wisconsin Medicaid Program since inception. 
• MetaStar began performing audits of health plans throughout the United States using the published NCQA HEDIS Compliance Audit™ Standards and Guidelines in 1997 and has been serving as a Data Validation Contractor since the inception of the project.

About MetaStar, Inc.
MetaStar Inc, based in Madison, WI, is a licensed NCQA HEDIS Compliance Audit™ Firm dedicated to ensuring effective, efficient and collaborative health care data validation services. Using objective, time-proven techniques, we work with providers and sponsors to validate processes and data, assuring the organization’s ability to meet critical reporting requirements. We do it by being an independent, credible, and reliable resource.

Contact
Amy W. Cleary, MBA, CHCA, CPHQ, MHP
Medicare Part C and D Data Validation Manager
(800) 362-2320, ext. 8220

HEDIS^® is a registered trademark of the National Committee for Quality Assurance (NCQA).
NCQA HEDIS Compliance Audit^™ is a trademark of the National Committee for Quality Assurance (NCQA).