Uncategorized Archives - Page 2 of 2

Audits CMS Uncategorized

CMS Discusses Draft 2019 Audit Protocols and More at Conferences

BluePeak Lists Top 5 Changes by Impact to Plan Sponsors Following a flurry of final and proposed rulemaking in April, the Centers for Medicare and Medicaid Services (CMS) discussed program…

BluePeak AdvisorsJune 7, 2018

Uncategorized

Ready or not-the 2018 Audit Season is Upon Us…

As Plans Continue to Struggle with the Same Common Conditions, CMS Makes Few Changes from the 2017 to 2018 Audit Protocols As the Centers for Medicare and Medicaid Services (CMS)…

BluePeak AdvisorsMarch 6, 2018

CMS HPMS Medicare Uncategorized

Decreased HSD Tables Application Requirement Now Leads to CMS Network Adequacy Review Later

Decreased HSD Tables Application Requirement Now Leads to CMS Network Adequacy Review Later Part C applications may have decreased requirements for the submission of a key management staff organizational chart…

BluePeak AdvisorsNovember 29, 2017

Street signs one stating 2018 and pointing left, the other stating 2019 and pointing right

CMS HPMS Medicare Uncategorized

Getting Ready for Early Application Tasks and Understanding 2019 Application Changes

Submit Notice of Intent to Apply (NOIA) Now Each year, the Centers for Medicare and Medicaid Services (CMS) accepts applications from new plan sponsors, as well as existing Medicare Advantage-Prescription…

BluePeak AdvisorsNovember 27, 2017

CMPs CMS Medicare News Uncategorized

CMS Expands Penalties in 2017: One-Third Financial Audit Findings Will Cost You More This Year

The Centers for Medicare & Medicaid Services (CMS) is now considering deficiencies found from one-third financial audits for potential enforcement actions, including Civil Money Penalties (CMPs), according to a memo…

Kim Mullins, MBASeptember 15, 2017

CMS Medicare News Uncategorized

You’re Going to Want BluePeak’s Online Provider Directory Review Service

From February to August, the Centers for Medicare & Medicaid Services (CMS) conducted the second round of online provider directory reviews of 64 Medicare Advantage Organizations (MAOs). CMS reviewed online…

BluePeak AdvisorsSeptember 15, 2017

ANOC/EOC CMS Compliance CPE CTM HPMS PBM Uncategorized

2018 is Around the Corner – Are You Ready?

Bid approved – check. Member materials sent to printer – check. What other items should be on your radar over the next few months? The Centers for Medicare and Medicaid…

Kim Mullins, MBASeptember 15, 2017

Audits CMS Compliance Part C Part D Past Performance Uncategorized

Past Performance, Encounters and Misclassifications, Oh My!

CMS denies applications due to Past Performance scores, encounter data volume is growing, and misclassification of appeals and grievances continues to be an issue. BluePeak tells you what you need…

Kim Mullins, MBASeptember 15, 2017