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Program : With regard to the oversight of the Managed Care program , the CMS central office staff will follow up with all regional offices to ensure that the regional offices follow the audit protocols for cost plans , demonstrations , and health care pre-payment plans , follow the Medicare + Choice / Medicare Advantage monitoring guide , and maintain adequate documentation to evidence these reviews . The financial planner needs to rely on cost numbers produced during the engineering and design process . This section addresses the financial risks to the cost estimates and how the financial plan can minimize those risks . In this and several other instances , the PRIME and the IRS have overestimated their ability to deliver projects on schedule and within cost estimates . Items that are not functionally part of the project , but that are necessitated by the project must be included in the cost estimates . The cost estimates for small plan compliance recognize only the cost of changes to existing practices associated with the regulations ; they exclude the impact of the statute itself . Also , the implicit assumption that , within an AIS severity level , the distribution of injuries across body regions is the same for motorcycles as for other vehicles is a troublesome one that could skew the cost estimates . Empirical analysis of 1970 data for a sample of 64 SMSAs suggests that crime diversions are the dominant externality and that cost reductions are the dominant effect of cooperation . An independent review is intended , in part , to provide program management some degree of assurance that the life-cycle cost estimates are reasonable and the cost estimates are built on realistic program assumptions .