BluePeak helps plans prepare for audits of their FFE Plan. BluePeak’s mock audits are conducted in a manner which simulates a real audit from The Centers for Medicare and Medicaid Services (CMS) and The Center for Consumer Information and Insurance Oversight (CCIIO).
The mock audit will include a formal audit announcement, set submission timeframes, an entrance and exit conference, as well as documentation review and case sampling of HICS Casework, Enrollments, Terminations and Renewal-Discontinuation Letters.
At the close of the audit BluePeak will provide a written report of key findings and observations. BluePeak will share industry best practices and make recommendations on effective corrective action plans.
Federally Facilitated Exchange (FFE) Audit Support
BluePeak supports Qualified Health Plans (QHPs) that have received their FFE audit notice. BluePeak’s support includes:
- Training on audit approach
- Review of documentation requested by CMS and feedback on how to improve the documentation
- Targeted practice sessions to focus on high-risk area
- Review and discussion of casework
- Attendance at all audit calls
- Support executive management with information, advice, and CMS expectations.
- Support the operational and compliance teams with subject matter expertise and/or the development of any materials
- Review draft report
- Provide assistance with Work Plan responses
- Assist with remediation and preparation for corrective action validation
- Provide a framework for future mock audit activities
We are your trusted partner.
We are a trusted partner to some of the most respected pharmacy and healthcare organizations, including: Medicare Advantage and Prescription Drug Plans, Medicaid Programs, Pharmacy Benefit Managers, Employers, Medicare related payers, such as SPAPs and ADAPs, as well as law firms, marketing firms and supporting entities.