November 2022 Archives - BluePeak Advisors

Consultant Corner November 2022 ODAG

Consultant Corner: Do Your ODAG Universes Have Integrity?

Jaymie Billbrough, RN, is a BluePeak senior health plan services consultant. Prior to 2022, The Centers for Medicare and Medicaid Services (CMS) provided Sponsoring Organizations (SO) with a 20% “margin…

Carmen WintersDecember 1, 2022

IRA November 2022

Part D Operational Implications of the Inflation Reduction Act (IRA) of 2022

On August 16th, the Inflation Reduction Act of 2022 (IRA) was signed into law. The text of the bill is located here and includes changes that, among other things, would…

BluePeak AdvisorsDecember 1, 2022

MA November 2022

Effective Strategies in Claims Quality Auditing

In light of ever rising benefit costs, employers and Medicare Advantage (MA) plans should consider regular claims quality auditing as part of an overall benefits and cost-containment strategy. Claims audits…

BluePeak AdvisorsDecember 1, 2022

MA MCMG Medicare November 2022

Risks in Misclassifying First Tier, Downstream, and Related Entities (FDRs)

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 November 2022 Part D

Minimizing Hospice Billing Concerns

What is the Issue?1 In August 2019, the Department of Health and Human Services Office of Inspector General (OIG) released a report entitled, Medicare Part D is Still Paying Millions…

BluePeak AdvisorsDecember 1, 2022