CMS Archives - BluePeak Advisors

Audits CMS Summer 2024

Upcoming IRA Changes for 2025: Key Considerations for Year End Testing

Since its passage, the Inflation Reduction Act (IRA) of 2022 has ushered in changes to the Medicare Part D benefit each contract year (CY) and 2025 is no different. Now…

BluePeak AdvisorsJune 24, 2024

CMS D-SNP MMP Summer 2024

Understanding Dual-Eligible Special Needs Plans (D-SNPs): Your essential guide to types of D-SNPs and the impact of MMPs Sunsetting

In May of 2022, CMS finalized the rule that will sunset Medicare-Medicaid Plans (MMPs). This rule proposes that required states transition their MMP enrollees to integrated Medicare Advantage dual eligible…

BluePeak AdvisorsJune 24, 2024

Audits CMS Spring 2024

What we know so far about 2024 Utilization Management Focused Audits

On April 12, 2023, the Centers for Medicare & Medicaid Services (CMS) released the 2024 Final Rule in the Federal Register (2024 Final Rule). Among other provisions, the Final Rule…

BluePeak AdvisorsMarch 29, 2024

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

CMS December 2023

The Centers for Medicare & Medicaid Services: 2024 Readiness Checklist for Medicare Advantage Organizations, Prescription Drug Plans

The Centers for Medicare & Medicaid Services (CMS) released the CY2024 Medicare Parts C and D Readiness Checklist on October 13, 2023. Although this is a busy time of year,…

BluePeak AdvisorsDecember 11, 2023

CMS December 2023 HHS SSBCI

Special Supplemental Benefits for the Chronically Ill: 2025 Proposed Rule Impacts to Consider

Believe it or not, it is already time to start thinking about plan benefits for contract year 2025. Plan sponsors continue to look for ways to grow membership, modify benefit…

BluePeak AdvisorsDecember 11, 2023

CMS December 2023 IRA

Inflation Reduction Act (IRA): 2024 Summary of Changes and Oversight Considerations

The Centers for Medicare & Medicaid Services (CMS) has released significant guidance to support the Inflation Reduction Act (IRA) provisions that impacts Medicare enrollees, health plans, pharmacy benefit managers (PBM)…

BluePeak AdvisorsDecember 11, 2023

CMS December 2023 Utilization Management

2024 Final Rule Changes: Impacts on Utilization Management Tools and Proposed Changes for 2025.

The Final Rule 2024 is one of the most substantive in recent years, with clarifications, codifications to existing rules and new requirements! Plans need to be well prepared this year…

BluePeak AdvisorsDecember 11, 2023

CMS February 2023 PACE

PACE Past Performance

CMS continues to move PACE Organizations into alignment with Medicare Advantage plans, and use of past performance to inform request for new or expanded PACE programs is no exception. While…

BluePeak AdvisorsFebruary 3, 2023

CMS November 2022 Part D

Minimizing Hospice Billing Concerns

What is the Issue?1 In August 2019, the Department of Health and Human Services Office of Inspector General (OIG) released a report entitled, Medicare Part D is Still Paying Millions…

BluePeak AdvisorsDecember 1, 2022