Fall 2022 Archives - BluePeak Advisors

Fall 2022 Part D

CMS Continues to Scrutinize Part D Claims and Coverage Determinations Process through Program Audits and Notices of Non Compliance

CMS Program Audit season is over and as anticipated, the volume of Program Audits in 2022 increased substantially over prior years. From a Part D perspective, audits have touched almost…

BluePeak AdvisorsSeptember 7, 2022

Fall 2022 Medicare

CY 2022 Part C and Part D Reporting Technical Specifications – Do You Know What Has Changed?

In June, CMS issued updated technical specifications for CY 2022 Medicare Part C and Part D reporting. BluePeak has summarized the key changes in the technical specifications below. BluePeak compared…

BluePeak AdvisorsAugust 25, 2022

Audits Fall 2022

CMS Announces Audits Targeting Fraud, Waste, and Abuse Beginning October 2022

Beginning October 2022 and continuing throughout 2023, CMS, in conjunction with the Plan Program Integrity Medicare Drug Integrity Contract (PPI MEDIC), will initiate three National Audits, six Self-Audits and four…

BluePeak AdvisorsAugust 25, 2022

Fall 2022 ODAG

97% Isn’t Good Enough: Why Every Decision Matters

The Organization Determinations, Appeal and Grievances (ODAG) area of a Centers for Medicare & Medicaid Services (CMS) Program Audit focuses on high-risk areas with the greatest potential for enrollee harm. …

BluePeak AdvisorsAugust 25, 2022