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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

Audits CDAG CMS CPE FA ODAG SARAG SNP-MOC

The 2019 CMS Program Audit Season is Upon Us!

CMS started issuing audit letters in March and will continue doing so through July. If you haven't already received an audit notice, what are you doing to prepare? 2019 starts…

BluePeak AdvisorsMarch 15, 2019

Audits CDAG CMS CPE FA ODAG SNP-MOC

Along with Other Trends, CMS Cites Common and New Findings in 2018 Program Audits

The end of September marks the end of the full 2018 Centers for Medicare and Medicaid Services (CMS) Program Audit season. Plans that have not yet received an audit engagement…

BluePeak AdvisorsSeptember 21, 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

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

Audits CDAG CTM FAA PBM TPMA

New Year’s Day is Ultimate Test of New Part D Plan Year Readiness

While most people are singing Auld Lang Sine at midnight on January 1, those of us in the Medicare world are anxiously awaiting the first claims of the plan year…

BluePeak AdvisorsNovember 27, 2017

Audits CMS CPE FDRs

BluePeak Offers Tips for Developing 2018 Risk Assessments and Monitoring and Auditing Work Plans

Annual risk assessments and associated monitoring and auditing work plans are not only required, but also help to ensure your compliance program is efficiently and effectively monitoring and auditing business…

BluePeak AdvisorsNovember 27, 2017

Audits CMS Compliance Part C Part D Past Performance Uncategorized

Past Performance, Encounters and Misclassifications, Oh My!

CMS denies applications due to Past Performance scores, encounter data volume is growing, and misclassification of appeals and grievances continues to be an issue. BluePeak tells you what you need…

Kim Mullins, MBASeptember 15, 2017