Delegate Oversight Compliance Vendor Checklist

Health plans often choose to outsource or delegate administrative functions to gain expertise, reduce administrative costs, increase capacity and increase speed to market. However, delegating authority to perform services is not the same as delegating responsibility for compliance of that service.

Any outsourced activity must still comply with the regulations, requirements, and/or standards set forth by the Centers for Medicare & Medicaid Services (CMS) and/or any other applicable federal or state regulatory authority.

If you outsource or plan to delegate functions for your health plan, this vendor checklist will guide you through details of the key areas needed for a formal Delegate Oversight Compliance Program.

• Accountability
• Auditing and monitoring
• Policies and procedures
• Training and education
• Communication protocols
• Compliance

Delegate Oversight Compliance Vendor Checklist

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