BluePeak Advisors, Author at BluePeak Advisors

HPMS Medicare PDBM

Medicare Advantage and Prescription Drug Plan Appeals Guidance– Are You Ready?

Chapter 13 of the Medicare Managed Care Manual (MMCM) and Chapter 18 of the Prescription Drug Benefit Manual (PDBM) have been consolidated into one chapter. CMS announced the release of…

BluePeak AdvisorsJune 12, 2019

CMS Medicaid Medicare

Call Centers Beware

On May 10, 2019, CMS published a final rule on Drug Pricing Transparency. The rule, effective July 9, 2019, requires direct-to-consumer television advertisements of prescription drugs and biological products payable…

BluePeak AdvisorsJune 11, 2019

Legal PBM

Question & Answer

Q: Is it permissible for the Compliance Officer to report to General Counsel or the Legal Department? A: While some Plans and PBMs do this, it is not ideal or…

BluePeak AdvisorsJune 11, 2019

Service Spotlight

Service Spotlight: Member Material Review

Are you drowning in developing and reviewing member material? Accuracy and timeliness are critical in all member communications. BluePeak’s consultants have experience reviewing member materials from their work at Plans…

BluePeak AdvisorsJune 11, 2019

CMS HPMS MA

Changes Ahead for Plan Finder

During the CMS Spring Conference on May 1, 2019, CMS reviewed some of the revisions that are being made to Plan Finder. The redesigned Plan Finder will be used this…

BluePeak AdvisorsJune 11, 2019

CHIP CMS HHS MA MA-PD QHP

Interoperability Rule-This Could Be a Big Deal!

The Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) have published several new proposed and final rules on various topics, ranging from prescription…

BluePeak AdvisorsJune 11, 2019

Audits CMPs HIPAA OCR

Is Your Organization Doing All You Can to Detect, Prevent and Correct HIPAA Violations?

On April 30, 2019, Health and Human Services (HHS) published a final rule in which they are exercising their discretion in how they apply regulations concerning the assessment of Civil…

BluePeak AdvisorsJune 11, 2019

CMS Marketing MCMG PDE Training

BluePeak’s Definitive Guide to Preparing for 2020

Bids were turned in the first Monday in June and now it is time to implement those benefits, plan designs and formularies that your organization has been hard at work…

BluePeak AdvisorsJune 11, 2019

ICYMI – BluePeak’s Articles Posted Recently On LinkedIn

Looking for more articles and insight from us? Head over to our LinkedIn page to discover more. Here are some of the recent articles posted there: CMS Announces Timeliness Monitoring…

BluePeak AdvisorsMarch 15, 2019

Audits CMS

BluePeak Service Spotlight: Universe Monitoring Service

On February 8, 2019, CMS released “CMS Program Audits Frequently Asked Questions (FAQs). One of the questions addressed was: “Will sponsoring organizations always have the opportunity to submit universes up…

BluePeak AdvisorsMarch 15, 2019