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Part C Organization Determinations, Appeals, and Grievances (ODAG)
The CMS program audit area covering how Part C plans handle coverage decisions, appeals and grievances.
ODAG is the program audit area this protocol covers. CMS uses it to evaluate a sponsoring organization's performance on Part C organization determinations, appeals and grievances. It tests three audit elements: timeliness, processing of coverage requests, and classification of requests, using six universe tables.
Source: ODAG protocol, Purpose, PDF p. 3.