Lisa B. Barker MBA, BSN, RN, CCM is a Senior Consultant, Part C Lead with BluePeak Advisors, a division of Gallagher Benefit Services, Inc.
“See One, Do One, Teach One” was the mantra of my Emergency Department Nursing orientation just after I passed my boards; I just dated myself, didn’t I?
It served me well 26 years ago as I began my nursing career and I continue to find it a beneficial means of learning, though maybe not so much at the bedside with patient safety at risk.
In a consulting role for an industry subject to CMS’ oversight and discretion, I always appreciate the opportunity to “see” one of my peers support a client during a “new” oversight procedure before I have to take the lead on supporting clients in a similar engagement. Even with years of reading for intent, supporting countless Plans through regulatory oversight activities, and conducting numerous mock engagements and validation audits, nothing compares to having an opportunity to observe CMS auditors firsthand as they implement new regulatory oversight procedures (especially when I get to “see” one before I “do” one”). My experience holds that our clients agree that “seeing” and knowing what transpires during a CMS audit, through BluePeak’s lens of experience, results in a better audit outcome.
Sharing insights through our collective BluePeak experiences and “teaching” strategies to successfully navigate regulatory engagements (not to mention celebrating with clients after they successfully employ those strategies) is one of my favorite things about consulting.
So, while this is understandably a stressful time for plans and delegates, it is a time of growth and learning for the industry! As expected, BluePeak is leading the way in 2024, supporting clients in routine and focused audits which assess for compliance with the coverage and UM requirements finalized in CMS-4201-F. We have seen one, done one, and are ready to teach many by sharing direct observations and experiences with our clients through mock audits and audit support. I will personally guarantee our experiences this week alone can provide at least three opportunities not likely considered when preparing and implementing the UM requirements of CMS-4201-F. To get you thinking: what, if any, are the risk of using authoritative compendia to make Part B drug determinations?
BluePeak can help!
Don’t’ delay, other than to like and share this post, reach out today so we can “teach” your operations and compliance teams what they must be prepared to demonstrate when selected to undergo a focused or routine program audit in 2024!
