Part C Archives - Page 2 of 3 - BluePeak Advisors

CMS FWA Medicare Part B Part C Part D

CMS Fraud Conference–Working Together to Combat Fraud

From July 16-18th over 100 investigative minds met at the annual CMS Fraud Conference in Miami, Florida to talk about current fraud schemes, emerging schemes, data analytics and how to…

BluePeak AdvisorsAugust 2, 2019

Call Letter CMS DMP Medicaid Medicare MME Part C

CMS Continues Along Its Roadmap to Address the Opioid Epidemic

Effective January 1, 2019, the Centers for Medicaid & Medicare Services (CMS) required plan sponsors to implement new opioid policies as part of the agency’s continued efforts to address the…

BluePeak AdvisorsMarch 15, 2019

Medicare Part C Part D

5 Universal Strategies to Move the Needle on Star Rating Improvements: A Medication Adherence Case Study

One of the surprises in the release of plans’ Star Ratings results for the 2019 open enrollment season was that Star Ratings around Part D adherence scores, on average, slipped.…

BluePeak AdvisorsDecember 1, 2018

CMS Medicare Part C Part D PBM

Proposed Rule Aimed at Drug Price Transparency Could Lead to Inadvertent Member Confusion

On October 18, 2018, the Centers for Medicare & Medicaid Services (“CMS”) published a proposed rule which, if finalized, will amend the Medicaid and Medicare Parts A, B, C, and…

BluePeak AdvisorsNovember 22, 2018

EHR EMR MPF Part C Part D Star Ratings

What are you doing to improve your Star Ratings?

As you checked your plan data that will be displayed on Medicare Plan Finder (MPF) for accuracy during the recent second plan preview, were you happy with your Star Ratings?…

BluePeak AdvisorsSeptember 21, 2018

CMPs CMS Part C Part D Uncategorized

BluePeak Services Spotlight: End-to-End Part C Claims Processing and Part D Claims Testing and Monitoring

In addition to the Centers for Medicare & Medicaid Services (CMS) program audits, a plan’s claims issues, such as not processing Low-Income Subsidies (LIS) correctly, can surface in one-third financial…

BluePeak AdvisorsSeptember 21, 2018

Call Letter CMS Medicare Part C Part D

Top Three Things Plans Need to Know to Manage and Improve Star Ratings

The release of the 2019 Call Letter, which allows plans to include quality improvement and member intervention costs in their bid, signals the Centers for Medicare and Medicaid Services’ (CMS’)…

BluePeak AdvisorsJune 26, 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

CMS Part C Part D PDE

PDE SELF AUDITS in 2018

Throughout 2017, CMS continued its vigilance over drug claim payments by conducting Prescription Drug Event (PDE) Self-Audits. The drugs under audit in 2018 may change, but CMS has not yet…

Kelly Makay, RPh. MBAJanuary 19, 2018

Audits CMS Compliance Part C Part D Past Performance Uncategorized

Past Performance, Encounters and Misclassifications, Oh My!

CMS denies applications due to Past Performance scores, encounter data volume is growing, and misclassification of appeals and grievances continues to be an issue. BluePeak tells you what you need…

Kim Mullins, MBASeptember 15, 2017