Part D Archives - Page 4 of 5 - BluePeak Advisors

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

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

ANOC/EOC CMS FDA HPMS Medicaid Medicare Part D

Indication-Based Formulary Design in CY2020

Beginning in the 2020 contract year (“CY2020”), the Centers for Medicare & Medicaid Services (“CMS”) will permit Part D sponsors to implement indication-based formulary designs that tailor formulary coverage of…

BluePeak AdvisorsSeptember 4, 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