CMS Archives - Page 3 of 9 - BluePeak Advisors

CMS HPMS MCMG

In Case You Missed It! CMS New Marketing Module Training–Big Changes Coming

On Friday May 28th, at 5pm ET, CMS will provide Plan Sponsors access to the new HPMS marketing module. The new marketing material module has enhanced functionality and will provide…

BluePeak AdvisorsMay 26, 2021

CMS COVID19 HPMS

CMS Releases a Flurry of Interim and Final Rules

CMS released several interim and final rules in the past month. As the new year starts and there is a change in administration, the pace of new guidance releases is…

BluePeak AdvisorsDecember 18, 2020

Audits CMS

Contract Year 2021 Monitoring of Posted Comprehensive Formularies

On November 2, 2020, CMS released the results of the CY2020 Monitoring of Posted Comprehensive Formularies or their Posted versus Approved (PvA) analysis. For the CY2020 analysis, CMS announced that…

BluePeak AdvisorsNovember 24, 2020

CMS

Perfect Storm

The last quarter of 2020 will likely be the most significant and the most challenging testing season plans have experienced. Unfortunately, there may be a perfect storm brewing that is…

BluePeak AdvisorsNovember 3, 2020

CMS FA

Annual Testing More Important than Ever

The most effective way for any Plan to mitigate any compliance risks for the new plan year is to strategize a process to validate the accuracy of the formulary and…

BluePeak AdvisorsSeptember 30, 2020

CMS Compliance MA Part C Part D

Encounter Data – It’s Not Just Claims Data Anymore.

Background On September 14, 2020 CMS released The Advance Notice of Methodological Changes for Calendar Year (CY) 2022 for Medicare Advantage (MA) Capitation Rates and Part C and Part D…

BluePeak AdvisorsSeptember 21, 2020

CMS ODAG Part B Uncategorized

Part B Drug Timeliness Monitoring and Management

On May 23, 2019, the Centers for Medicare & Medicaid Services (CMS) published a final rule (CMS-4180-F) which adopted new processing timeframe requirements for preservice organization determinations and plan reconsiderations…

BluePeak AdvisorsJune 13, 2020

Audits CMS CPE

Benefits of a Compliance Program Effectiveness Audit– Going Beyond Just Meeting the Requirement

CMS guidance requires Medicare Advantage Plans to have an independent audit of their compliance program’s effectiveness each year. Given competing priorities, it may be tempting to conduct a limited or…

BluePeak AdvisorsJune 13, 2020

CMS Medicare Part D

Initial Adoption of Indication-Based Formularies as a Formulary Management Tool

In August of 2018, CMS announced that Medicare Part D Sponsors have the option to use indication-based formularies starting January 1, 2020. Prior to this change, formulary medications were considered…

BluePeak AdvisorsApril 29, 2020

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