MA Archives - BluePeak Advisors, LLC

Enrollment ESRD MA

Compliance and Operational Considerations for Medicare Advantage Plans with Increasing Enrollment of End Stage Renal Disease (ESRD) Beneficiaries

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

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

COVID19 MA SEPs Star Ratings SUPD

Operational Impact of the Contract Year 2021 Final Rule

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

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

DMP MA PACE Part C Part D RTBT

10 Things Plans Need to Know about the 2021 and 2022 Policy and Technical Changes Proposed Rule

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

CMS HPMS MA

Changes Ahead for Plan Finder

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

CHIP CMS HHS MA MA-PD QHP

Interoperability Rule-This Could Be a Big Deal!

The Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) have published several new proposed and final rules on various topics, ranging from prescription…

BluePeak AdvisorsJune 11, 2019

Compliance IRE MA MA-PD Part D PBM

Using Interim Staffing to bring Appeals and Grievances Timeliness into Compliance–A Case Study

Sometimes, life happens. Turnover, volume increases, changing guidance, system changes or audit issues that require remediation all can create situations where a Plan or PBM needs expert resources fast. And…

BluePeak AdvisorsMarch 15, 2019

CMS MA Medicare Part D PDP

Drum Roll Please…The 2019 Medicare Enrollment Numbers are In.

2019 is already off to a blazing start with the implementation of Medicare Part D plans’ new opioid edits as well as 2020 formulary development. While plans are already preparing…

BluePeak AdvisorsFebruary 8, 2019

MA