Medicare Data Validation Readiness

(return to MetaStar Readiness Series)

Prepare with confidence before your CMS Part C & Part D audit.

MetaStar’s Medicare Data Validation Readiness service is designed to help Medicare Advantage and Part D plan sponsors proactively prepare for the Centers for Medicare & Medicaid Services (CMS)-mandated data validation audits. Whether you are a first-time participant or a seasoned plan managing multiple contracts, this program gives your team the tools, insight, and support to navigate the audit with clarity and control.

Our readiness approach simulates CMS audit protocols and draws directly from the official Data Validation Procedure Manual, interview guide, scoring methodology, and technical specifications. The goal—reduce audit risk, surface data or workflow issues before they are scored, and strengthen internal controls that support accurate CMS reporting.

What’s Included

• Customized mock interviews modeled after CMS’s Appendix F Interview Discussion Guide.
• Pre-audit documentation review, including organizational assessments, sampling protocols, and system workflows.
• Validation walkthroughs to trace reported values to source files.
• Scoring simulations using CMS-aligned pass/not pass methodology (Appendix J).
• Targeted feedback reports identifying gaps, inconsistencies, and CMS compliance risks.
• Technical coaching for audit leads and reporting staff.
• Best practice guidance for data governance, reporting logic, and audit file preparation.

Medicare Data Validation Readiness Is Ideal For

• Contracts preparing to undergo data validation for the first time.
• Plans launching new Medicare products or transitioning to new vendors.
• Organizations that previously failed one or more data validation reporting sections.
• Teams seeking to improve audit performance without formal penalties.

Why It Matters

The CMS annual Data Validation audit plays a critical role in verifying the accuracy of key Part C and Part D reporting sections. A failed audit can result in corrective action plans, system access concerns, and reputational risk. MetaStar’s readiness support helps you minimize those risks while reinforcing your internal culture of data quality and compliance.

Let’s Get Ready

Whether you are managing a complex multi-contract audit or want to proactively test your readiness, MetaStar is here to help. Our goal is the same as yours: no surprises on audit day.