Part D Archives - Page 2 of 5 - BluePeak Advisors

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

Audits CMS Medicare Part D

Will Your Grievance Resolution Letters Stand Up in an Audit?

Across the Medicare Advantage and Part D industry, Plans are nervous about how their grievance resolution letters will present and stand the test in a CMS Program Audit. BluePeak Advisors…

BluePeak AdvisorsFebruary 18, 2022

AEP MCMG Member Materials Part D

Service Spotlight: Comprehensive Support from Bid to AEP and Beyond…

On February 9, 2022 CMS released the Medicare Advantage and Part D Communications & Marketing Guidelines (MCMG) reminding us all of what we already know- it’s time to begin planning…

BluePeak AdvisorsFebruary 12, 2022

CMS Medicare Part D

Two Rules With Potential Part D Rebate Access Impact

Two rules have the potential to impact how Part D price concessions and pharmaceutical rebates are managed and how these changes, when implemented, will subsequently impact a Part D sponsor’s…

BluePeak AdvisorsFebruary 9, 2022

CMS HPMS Part D

Annual Transition Policy and Attestation Submission to CMS

The Centers for Medicare and Medicaid Services (CMS) requires, as part of the formulary submission process, each plan sponsor complete the Transition Policy Attestation through the formulary submission module in…

BluePeak AdvisorsFebruary 9, 2022

MA Part C Part D Star Ratings

Early Release of Medicare Advantage and Part D Advance Notice: Part C & D Star Rating Changes

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

Claims CSR Formulary Part D

Senior Savings Model-Tips for a Successful Implementation

Participation is expected to be strong in the Part D Senior Savings Model launch on 1/1/21 with 1,750 plans across 88 sponsors and 3 manufacturers participating in the program. Participating…

BluePeak AdvisorsDecember 18, 2020

Compliance Medicare Part D

Top 3 Key Regulatory Changes for 2021

There are several noteworthy regulatory changes that require action by Medicare Advantage and Part D Plans in 2021. 1. Provider-Facing Electronic Real-Time Benefit Tool (RTBT) CMS issued a final rule…

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