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Mock Federally Facilitated Exchange (FFE) Audits

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.

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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.

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