BluePeak Advisors, Author at BluePeak Advisors

Part D Podcast

BluePeak Podcast: Part D Benefit Changes on the Horizon and What does It Mean

One of the biggest Part D changes revealed in the 2019 Call Letter was the closure of the Coverage Discount Gap Program a year earlier than scheduled. As a result,…

BluePeak AdvisorsJune 17, 2018

ICYMI – BluePeak’s Articles posted recently on LinkedIn

BPA Connection Matches Healthcare Job Seekers and Employers - https://www.linkedin.com/feed/update/urn:li:activity:6380517376378564608 BluePeak’s End-to-End Part C Claims Processing Audit Finds Deficiencies BEFORE CMS Does - https://www.linkedin.com/feed/update/urn:li:activity:6381527793406083073 BluePeak Shares “2019 Final Call Letter…

BluePeak AdvisorsJune 7, 2018

CMS EOBs

BluePeak Service Spotlight: Member Material Review

BluePeak’s consultants have experience reviewing member materials from their work at Plans and for the Centers for Medicare and Medicaid Services (CMS). We can help you populate and/or review the…

BluePeak AdvisorsJune 7, 2018

Audits CMPs CMS CPE

CMS Annual Report Shows Audit Scores and CMPs Decreased, Common Conditions Repeated in 2017

From 2016-2017, audit scores were lower in all areas, except Compliance Program Effectiveness (CPE); Civil Money Penalties (CMPs) were significantly reduced; and most Common Conditions were repeated, according to the…

BluePeak AdvisorsJune 7, 2018

CMS Marketing MCMG Medicare

CMS Updates Definition of Marketing, Reduces Required Hard Copy Member Materials

The Centers for Medicare and Medicaid Services (CMS) typically issues a draft version of the Medicare Marketing Guidelines (MMG) early in the year for comment before releasing the final version…

BluePeak AdvisorsJune 7, 2018

Audits CMS Uncategorized

CMS Discusses Draft 2019 Audit Protocols and More at Conferences

BluePeak Lists Top 5 Changes by Impact to Plan Sponsors Following a flurry of final and proposed rulemaking in April, the Centers for Medicare and Medicaid Services (CMS) discussed program…

BluePeak AdvisorsJune 7, 2018

CMS FWA Part D PDE RAPS

CMS Increases Percentage of Encounter Data on Which MA Plans’ Payments are Based

According to the Final Call Letter, the Centers for Medicare and Medicaid Services (CMS) will increase the percentage of encounter data, on which part of Medicare Advantage plans’ pay is…

BluePeak AdvisorsMay 15, 2018

Podcast

BluePeak Podcast: Initial Thoughts on CMS 2018 Spring Conference

Tune into BluePeak’s newest podcast, to hear Principal Babette Edgar and Senior Consultant Susan Herman discuss their initial thoughts on last week’s CMS 2018 Medicare Advantage & Prescription Drug Plan Spring…

BluePeak AdvisorsMay 14, 2018

Call Letter

BluePeak Releases Summaries and Webinar Covering 2019 Call Letter

Bluepeak Subject Matter Experts (SME) have reviewed the 2019 Call Letter and created the following for your reference. 2019 Call Letter Summary Detailed overview of this year’s changes and what…

BluePeak AdvisorsMay 1, 2018

CDAG CMPs ICARs IRE ODAG

Appeals and IRE Data Issues Can Impact Audit Scores, Star Ratings and CMPs

Whether deficiencies are discovered as part of a CMS program audit or a Timeliness Monitoring Project (TMP) review, issues with appeals and Independent Review (IRE) data can impact a plan’s Star Ratings…

BluePeak AdvisorsMarch 6, 2018