BluePeak Advisors, Author at BluePeak Advisors

CMS MA Medicare Part D PDP

Drum Roll Please…The 2019 Medicare Enrollment Numbers are In.

2019 is already off to a blazing start with the implementation of Medicare Part D plans’ new opioid edits as well as 2020 formulary development. While plans are already preparing…

BluePeak AdvisorsFebruary 8, 2019

FDRs Medicare Part D Uncategorized

Ensuring Record Retention Requirements with First-tier, Downstream and Related Entities (FDR’s).

Many Medicare Plans may believe compliance with the ten-year record retention requirement is a slam-dunk. However, plans are often tripped up in audits because their first-tier and downstream entities do…

BluePeak AdvisorsFebruary 1, 2019

HIPAA OCR

BluePeak Service Spotlight: HIPAA Program Review

HIPAA Violations = Potential Civil Fines and Criminal Penalties How healthy is your HIPAA Program? BluePeak’s HIPAA Program Review can help you identify and correct privacy, security and breach policy and procedure issues that might leave…

BluePeak AdvisorsDecember 7, 2018

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: Claim Accuracy is More…

BluePeak AdvisorsDecember 7, 2018

CMS Part D

Prepared to Implement the CMS Preclusion List Requirement?

Along with the new year also comes a new CMS requirement known as the Preclusion List. This requirement was adopted in the April 2018 final rule as an alternative to…

BluePeak AdvisorsDecember 3, 2018

Medicare Part C Part D

5 Universal Strategies to Move the Needle on Star Rating Improvements: A Medication Adherence Case Study

One of the surprises in the release of plans’ Star Ratings results for the 2019 open enrollment season was that Star Ratings around Part D adherence scores, on average, slipped.…

BluePeak AdvisorsDecember 1, 2018

CMS MBI Medicare Open Enrollment Part D

Is Your Plan Ready for the New Year?

Annual Notices of Changes (ANOC) shared with enrollees Evidence of Coverage (EOC) shared with enrollees Formulary shared with enrollees Pharmacy and Provider Directories shared with enrollees Medicare Communications Marketing Guidelines…

BluePeak AdvisorsDecember 1, 2018

CMS EOC FDA Part D

Formulary Strategy Planning for 2020-Indication Based Formulary Design Considerations

The 2019 plan year has not commenced, yet plans are already developing formulary strategies for 2020. Indication-based formulary designs will add a new twist for plan sponsors to consider as…

BluePeak AdvisorsDecember 1, 2018

CMS TPMA Uncategorized

Transition Monitoring Program Audit-Coming Soon!

History and Methodology The transition monitoring program analysis (TMPA) has been in effect since 2012 and will likely be a staple in the Part D program for several years to…

BluePeak AdvisorsDecember 1, 2018

CMS Medicare Part C Part D PBM

Proposed Rule Aimed at Drug Price Transparency Could Lead to Inadvertent Member Confusion

On October 18, 2018, the Centers for Medicare & Medicaid Services (“CMS”) published a proposed rule which, if finalized, will amend the Medicaid and Medicare Parts A, B, C, and…

BluePeak AdvisorsNovember 22, 2018