CDAG Archives - BluePeak Advisors

CDAG CPE FA June 2023 ODAG SNP-MOC

2023 CMS Program Audit Trends and Key Details: What We Know So Far

On November 30, 2022, the Centers for Medicare and Medicaid Services (CMS) Medicare Parts C and D Oversight and Enforcement Group (MOEG) announced the 2023 program audit updates. CMS is…

BluePeak AdvisorsJune 1, 2023

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 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

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

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

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

CDAG CMS CPE FDRs ODAG TPMA

CMS Increases Scrutiny of FDRs, Finds Common Conditions During 2017 Program Audits

During the 2017 audit season, BluePeak observed increased CMS increased scrutiny on plans and their First Tier, Downstream and Related Entities (FDRs), as well as repeated Common Conditions. With limited changes from…

BluePeak AdvisorsNovember 27, 2017

CDAG CMS CPE FDRs PBM

Opioid Epidemic Spotlights Health Plans’ FWA Investigations

On October 26, President Donald Trump declared the nation’s opioid epidemic a public health emergency. The opioid epidemic is the deadliest drug epidemic in American history. Deaths from opioid overdose…

Michelle Rigby, CFENovember 3, 2017