Part D Archives - Page 4 of 6 - BluePeak Advisors

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

FDRs Medicare Part D Uncategorized

Ensuring Record Retention Requirements with First-tier, Downstream and Related Entities (FDR’s).

Many Medicare Plans may believe compliance with the ten-year record retention requirement is a slam-dunk. However, plans are often tripped up in audits because their first-tier and downstream entities do…

BluePeak AdvisorsFebruary 1, 2019

CMS Part D

Prepared to Implement the CMS Preclusion List Requirement?

Along with the new year also comes a new CMS requirement known as the Preclusion List. This requirement was adopted in the April 2018 final rule as an alternative to…

BluePeak AdvisorsDecember 3, 2018

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 MBI Medicare Open Enrollment Part D

Is Your Plan Ready for the New Year?

Annual Notices of Changes (ANOC) shared with enrollees Evidence of Coverage (EOC) shared with enrollees Formulary shared with enrollees Pharmacy and Provider Directories shared with enrollees Medicare Communications Marketing Guidelines…

BluePeak AdvisorsDecember 1, 2018

CMS EOC FDA Part D

Formulary Strategy Planning for 2020-Indication Based Formulary Design Considerations

The 2019 plan year has not commenced, yet plans are already developing formulary strategies for 2020. Indication-based formulary designs will add a new twist for plan sponsors to consider as…

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

CMS MAT Medicare MME Opioids Part D PBM

CMS Continues to Deploy Revised Strategies to Assist with Identifying and Deterring Opioid Abuse

To assist Medicare Part D sponsors with monitoring efforts and potentially avoid overutilization of opioids in the elderly Medicare population, CMS has deployed numerous strategies over the past several years…

BluePeak AdvisorsSeptember 21, 2018