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
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
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
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
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
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
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
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
As plans work through the biggest changes to the Medicare Marketing Guidelines since its inception – including changing the name of the guidance to the Medicare Communications and Marketing Guidelines…
BluePeak AdvisorsAugust 24, 2018