Lisa Barker is BluePeak Part C Lead Providers, Industry Groups and the Office of Inspector General (OIG) have been very vocal about concerns for prior authorization requirements creating barriers that…
Lisa BarkerFebruary 3, 2023
There are a number of criteria outlining the oversight of First Tier, Downstream and Related Entities for Medicare Advantage Organizations. Chapters 21 / 9 and 11 of the Medicare Managed…
BluePeak AdvisorsDecember 1, 2022
CMS published Part I of the Advance Notice of Methodological Changes for Calendar Year (CY) 2022 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies…
BluePeak AdvisorsDecember 18, 2020
For the first time, starting in 2021, the 21st Century Cures Act allows beneficiaries diagnosed with ESRD to enroll in MA plans. These beneficiaries have previously been required to stay on Medicare Fee-for-Service…
BluePeak AdvisorsSeptember 30, 2020
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
Operational Impact of the Contract Year 2021 Final Rule On June 2, 2020 CMS released the Contract Year 2021 and 2022 Policy and Technical Changes to the Medicare Advantage Program,…
BluePeak AdvisorsJune 17, 2020
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
On February 5, 2020, the Centers for Medicare & Medicaid Services (CMS) announced it will not be publishing a Call Letter for 2021. Rather, CMS is codifying guidance typically published…
BluePeak AdvisorsFebruary 25, 2020
During the CMS Spring Conference on May 1, 2019, CMS reviewed some of the revisions that are being made to Plan Finder. The redesigned Plan Finder will be used this…
BluePeak AdvisorsJune 11, 2019