CPE 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

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

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

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 CPE Part C Part D

Highlights of CMS-Proposed Changes in Draft 2019 Call Letter

The Centers for Medicare and Medicaid Services (CMS) proposes changes to Star Ratings, validation audits, annual Compliance Program Effectiveness (CPE) audits, Part D opioid overutilization policy, and more in the…

BluePeak AdvisorsMarch 6, 2018

Audits CMS CPE FDRs

BluePeak Offers Tips for Developing 2018 Risk Assessments and Monitoring and Auditing Work Plans

Annual risk assessments and associated monitoring and auditing work plans are not only required, but also help to ensure your compliance program is efficiently and effectively monitoring and auditing business…

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