CMPs Archives - BluePeak Advisors

CMPs CMS IRA Medicare NABA NONC Part D Spring 2024

The Importance of Medicare Marketing Material Development and Review, New changes coming and 2024 finding examples

Member materials are an important part of the Medicare member experience with a plan. Each year as Plan Sponsors finalize their product bid filing, CMS releases the upcoming plan year…

BluePeak AdvisorsMarch 29, 2024

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

Audits CMPs HIPAA OCR

Is Your Organization Doing All You Can to Detect, Prevent and Correct HIPAA Violations?

On April 30, 2019, Health and Human Services (HHS) published a final rule in which they are exercising their discretion in how they apply regulations concerning the assessment of Civil…

BluePeak AdvisorsJune 11, 2019

CMPs CMS Part C Part D Uncategorized

BluePeak Services Spotlight: End-to-End Part C Claims Processing and Part D Claims Testing and Monitoring

In addition to the Centers for Medicare & Medicaid Services (CMS) program audits, a plan’s claims issues, such as not processing Low-Income Subsidies (LIS) correctly, can surface in one-third financial…

BluePeak AdvisorsSeptember 21, 2018

CMPs CMS Podcast

BluePeak Podcast: Cost of Non-Compliance

The Facts are Sobering: CMPs may be the least expensive part of being non-compliant. CMS audits are on the rise, as are CMPs and sanctions. The average CMP is around…

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

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

CMPs CMS Medicare News Uncategorized

CMS Expands Penalties in 2017: One-Third Financial Audit Findings Will Cost You More This Year

The Centers for Medicare & Medicaid Services (CMS) is now considering deficiencies found from one-third financial audits for potential enforcement actions, including Civil Money Penalties (CMPs), according to a memo…

Kim Mullins, MBASeptember 15, 2017

CMPs CMS Medicare Part C Part D

Cost of Non-Compliance

Did you know... Forty-six percent of sponsors subject to a 2016 Program Audit received a Civil Money Penalty (CMP) for violations of Medicare Parts C and D requirements found by…

Michelle Rigby, CFEJuly 17, 2017

CMPs CMS Medicare Part C Part D PBM

CMS Expands Penalties in 2017

One-Third Financial Audit Findings Will Cost You More This Year The Centers for Medicare & Medicaid Services (CMS) is now considering deficiencies found from one-third financial audits for potential enforcement…

Angela MuncyJuly 7, 2017