Who reviews to determine if an audit is ready to move to the Close out phase?

• A. Centers for Medicare and Medicaid Services
• B. Centers for Disease Control and Prevention
• C. Food and Drug Administration
• D. National Institutes of Health

Answer: (A)

The agency responsible for deciding when an audit can move to the Closeout phase is CMS—the Centers for Medicare & Medicaid Services. They oversee Medicare and Medicaid audits and are the ones to review the findings, ensure all issues are resolved, and confirm that the audit file is complete before issuing the final report. The other agencies—CDC, FDA, and NIH—do not conduct this type of payer-side billing and reimbursement audits; they focus on public health surveillance, regulatory oversight of products, and biomedical research, respectively.