CMS had concerns that the CO-OPs established as part of the Affordable Care Act were not complying with the requirements noted in the Loan Agreement. Some of the issues noted were segregation of duties, non-compliance with reporting requirements to CMS, and contracting issues.
• Sustainment & Remediation
• Risk Assessment & Management
• Business Process Optimization
• Performance Management/Improvement
• Program Management
We provided the CO-OPs with audit and review reports identifying areas of non-compliance and areas where they could improve business processes. Review reports identified areas where CMS could improve, elaborate, and provide additional guidance to the CO-OP, including modifications to the loan agreement.