Uncategorized Archives - BluePeak Advisors

Uncategorized

Important: Opportunity for PACE Organizations to Comment on CMS Proposed Updates

CMS has announced a 30-day comment period for the proposed collection entitled “The PACE Organization (PO) Monitoring and Audit Process” (CMS-10630; OMB control number: 0938–1327). This notice was published on…

BluePeak AdvisorsJuly 21, 2025

Uncategorized

Biden Administration Immediate Actions May Affect Health Plans

President Biden hit the ground running, signing a batch of Executive Orders just hours after he was sworn in as the 46th President of the United States. A couple of…

BluePeak AdvisorsJanuary 22, 2021

Uncategorized

CMS announced they will be performing a 2021 transition of care audit using the Transition Requirements Analysis (TR)

CMS announced they will be performing a 2021 transition of care audit using the Transition Requirements Analysis (TR) that was piloted back in 2019. Although the 2019 TRA did not…

Amy DryerJanuary 8, 2021

CMS ODAG Part B Uncategorized

Part B Drug Timeliness Monitoring and Management

On May 23, 2019, the Centers for Medicare & Medicaid Services (CMS) published a final rule (CMS-4180-F) which adopted new processing timeframe requirements for preservice organization determinations and plan reconsiderations…

BluePeak AdvisorsJune 13, 2020

Uncategorized

Confused about Data Availability Requirements as a Result of the Interoperability Rule and the Real Time Benefit Tool? BluePeak has you Covered!

Over the course past year, CMS issued several different proposed and final rules that address making certain data available in a real-time or near real-time manner. The table below summarizes…

BluePeak AdvisorsJune 13, 2020

CMS MA Uncategorized

CMS Releases Final Rule on Interoperability and Patient Access

On March 9, 2020, the Centers for Medicare & Medicaid Services (CMS) released the final rule (CMS-9115-F) regarding Interoperability and Patient Access. While CMS issued a fact sheet regarding this rule, this rule…

BluePeak AdvisorsMarch 18, 2020

LinkedIn Uncategorized

ICYMI – BluePeak’s Articles Posted Recently On LinkedIn

Looking for more articles and insight from us? Head over to our LinkedIn page to discover more. Here are some of the recent articles posted there: Audit Tip #3-- It’s…

BluePeak AdvisorsJune 19, 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 TPMA Uncategorized

Transition Monitoring Program Audit-Coming Soon!

History and Methodology The transition monitoring program analysis (TMPA) has been in effect since 2012 and will likely be a staple in the Part D program for several years to…

BluePeak AdvisorsDecember 1, 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