Part D Archives - BluePeak Advisors

Fall 2024 Part D

Part D Audit Insights for CY2024: Key Takeaways

As the CY2024 audit season wraps up, the Centers for Medicare and Medicaid Services (CMS) has been publishing both draft and final reports for those selected for program audits. We…

BluePeak AdvisorsSeptember 23, 2024

CMS Fall 2024 IVR M3P Member Materials Part C Part D SSBCI

2025 Plan Readiness: Are You Prepared?

As you put the final touches on Plan Year 2025 implementation, it is crucial for Medicare plans to stay ahead of the game and be prepared for the changes that…

BluePeak AdvisorsSeptember 23, 2024

Audits Medicare Part D Spring 2024 Utilization Management

What Risk Does the new TERM Table Really Pose?

Have you heard about the new table initially required in the CMS Utilization Management (UM)-Focused audits? Also, known as “Table 7”, Plans need to ensure an ability to report accurate…

BluePeak AdvisorsMarch 29, 2024

IRA Part D Spring 2024

The Part D Tongue Twister and Brain Teaser also known as the Medicare Prescription Payment Plan

The Inflation Reduction Act (IRA) was signed into law in August 2022 with the goal of expanding Part D benefits, lowering drug costs, and improving the sustainability of the Medicare…

BluePeak AdvisorsMarch 29, 2024

CMPs CMS IRA Medicare NABA NONC Part D Spring 2024

The Importance of Medicare Marketing Material Development and Review, New changes coming and 2024 finding examples

Member materials are an important part of the Medicare member experience with a plan. Each year as Plan Sponsors finalize their product bid filing, CMS releases the upcoming plan year…

BluePeak AdvisorsMarch 29, 2024

December 2023 Opioids Part D

Is Your Part D Stars Program Ready to Ring in the New Year?

On April 12, 2023, Centers for Medicare & Medicaid Services (CMS) published the 2024 Final Rule that postponed moving the three polypharmacy measures (Concurrent Use of Opioids and Benzodiazepines, Polypharmacy…

BluePeak AdvisorsDecember 11, 2023

FDR MA Part D September 2023

Changes to CMS Requirements for Translation and Alternate Formats

To ensure effective communication and meaningful access, Medicare Advantage (MA) and Prescription Drug Plans (PDPs) have been obligated to follow various, occasionally interconnected directives for translating member documents into different…

BluePeak AdvisorsSeptember 7, 2023

February 2023 Medicare Part A Part B Part C Part D

BluePeak provides fresh insight into the CMS Proposed Rule for 2024

On December 27, 2022, the Centers for Medicare & Medicaid Services (CMS) published proposed rule (CMS_FRDOC_0001-3474) in the Federal Register. If finalized, this proposed rule would revise the Medicare Advantage…

BluePeak AdvisorsFebruary 3, 2023

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

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