CMS Archives - Page 7 of 9 - BluePeak Advisors

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

CMS EOC HPMS Marketing MCMG Medicare

Medicare Communications Marketing Guidelines: A Primary Topic at the CMS Fall Conference

BluePeak Highlights the Changes to MCMG Requirements The Centers for Medicare & Medicaid Services (CMS) 2018 Medicare & Prescription Drug Plan Fall Conference and Webcast kicked off on Thursday, September…

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

ANOC/EOC CMS FDA HPMS Medicaid Medicare Part D

Indication-Based Formulary Design in CY2020

Beginning in the 2020 contract year (“CY2020”), the Centers for Medicare & Medicaid Services (“CMS”) will permit Part D sponsors to implement indication-based formulary designs that tailor formulary coverage of…

BluePeak AdvisorsSeptember 4, 2018

ANOC/EOC CMS EOC Marketing MCMG Medicare Uncategorized

CMS to Provide Training on the New Medicare Communications and Marketing Guidelines at Upcoming Fall Conference

As plans work through the biggest changes to the Medicare Marketing Guidelines since its inception – including changing the name of the guidance to the Medicare Communications and Marketing Guidelines…

BluePeak AdvisorsAugust 24, 2018

Call Letter CMS Medicare Part C Part D

Top Three Things Plans Need to Know to Manage and Improve Star Ratings

The release of the 2019 Call Letter, which allows plans to include quality improvement and member intervention costs in their bid, signals the Centers for Medicare and Medicaid Services’ (CMS’)…

BluePeak AdvisorsJune 26, 2018

CMS EOBs

BluePeak Service Spotlight: Member Material Review

BluePeak’s consultants have experience reviewing member materials from their work at Plans and for the Centers for Medicare and Medicaid Services (CMS). We can help you populate and/or review the…

BluePeak AdvisorsJune 7, 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

CMS Marketing MCMG Medicare

CMS Updates Definition of Marketing, Reduces Required Hard Copy Member Materials

The Centers for Medicare and Medicaid Services (CMS) typically issues a draft version of the Medicare Marketing Guidelines (MMG) early in the year for comment before releasing the final version…

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