BluePeak Advisors, Author at BluePeak Advisors

CMS MA Uncategorized

CMS Releases Final Rule on Interoperability and Patient Access

On March 9, 2020, the Centers for Medicare & Medicaid Services (CMS) released the final rule (CMS-9115-F) regarding Interoperability and Patient Access. While CMS issued a fact sheet regarding this rule, this rule…

BluePeak AdvisorsMarch 18, 2020

CMS Part C Part D

Provider Directory Accuracy Monitoring and Use of the National Plan & Provider Enumeration System (NPPES)

On March 11, 2020 the CMS Part C and D User Call focused on Provider Directory accuracy and how the NPPES may support such accuracy. In case you missed it,…

BluePeak AdvisorsMarch 18, 2020

CMS IDS Part C Part D UMS

Universe Monitoring Service Case Study and Service Spotlight

Many of the proposed audit protocol changes for both the 2020 and 2021 audit season included changes to universes. An incomplete and incorrect universe can add 1 point toward your…

BluePeak AdvisorsMarch 18, 2020

CARA CDAG FA Opioids Part D

Is Your Opioid Program Compliant?

In 2019, Medicare introduced new policies for opioid prescriptions in the Medicare Part D prescription drug program to encourage pharmacies, prescribers, and Medicare drug plans to work together with the…

BluePeak AdvisorsMarch 18, 2020

Audits Call Log Review CMS Part C Part D Star Ratings

Accurate Call Classification and Handling-Strategies for Evaluating and Monitoring Your Customer Service Team

The Centers for Medicare & Medicaid Services (CMS) released an HPMS memo on August 20, 2019 providing an overview of the upcoming changes to program audits through 2021. These changes…

BluePeak AdvisorsMarch 18, 2020

Audits CMPs CMS

Civil Money Penalty Actions and Audit Trends

On 2/28/2020, CMS released the Civil Money Penalty (CMP) Enforcement Actions for 2019 Program Audits. Contract year 2019 was the first year of this audit cycle and we have incorporated…

BluePeak AdvisorsMarch 18, 2020

DMP MA PACE Part C Part D RTBT

10 Things Plans Need to Know about the 2021 and 2022 Policy and Technical Changes Proposed Rule

On February 5, 2020, the Centers for Medicare & Medicaid Services (CMS) announced it will not be publishing a Call Letter for 2021. Rather, CMS is codifying guidance typically published…

BluePeak AdvisorsFebruary 25, 2020

CMS QBP Star Ratings

Proposed Changes to MA and Part D Prescription Drug Program Quality Rating System from the 2021 and 2022 Policy and Technical Changes Proposed Rule

In the 2021 and 2022 Policy and Technical Changes Proposed Rule, CMS is proposing routine measure updates and an increase in the weight of patient experience/complaints and access measures. It…

BluePeak AdvisorsFebruary 25, 2020

DMP

2021 and 2022 Policy and Technical Changes Proposed Rule Could Impact Drug Management Programs

As plans prepare their drug management programs (DMPs) for CY2021 and beyond, there are several opioid provisions that must be implemented if this proposed rule (CMS-4190-P) is finalized. Below is…

BluePeak AdvisorsFebruary 25, 2020

Audits CDAG CPE FA ODAG SNP-MOC

New Audit Protocols are Coming in 2021

On December 6, 2019 CMS issued the HPMS Memo titled “Proposed Collection for New Medicare Part C and Part D Program Audit and Industry-Wide Part C Timeliness Monitoring Project (TMP)…

BluePeak AdvisorsFebruary 5, 2020