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 changes from the 2019 Final Call Letter, 2019 Final Rule and Draft 2019 Program Audit Protocols during their annual Medicare Advantage (MA) and Prescription Drug Plan (PDP) Spring and Audit & Enforcement conferences in May.

BluePeak analyzed the information from the conferences and came up with a Top 5 list of changes that will impact plan sponsors the most. Click to read our Top 5.
CMS Annual Report Shows Audit Scores and CMPs Decreased, Common Conditions Repeated in 2017

From 2016-2017, audit scores were lower in all areas, except Compliance Program Effectiveness (CPE); Civil Money Penalties (CMPs) were significantly reduced; and most Common Conditions were repeated, according to the 2017 Part C and Part D Program Audit and Enforcement Report the Centers for Medicare and Medicaid Services (CMS) released May 8. Click to read more and see tables for common conditions findings.
CMS Updates Definition of Marketing, Reduces Required Hard Copy Member Materials

The Centers for Medicare and Medicaid Services (CMS) typically issues a draft version of the Medicare Marketing Guidelines (MMG) early in the year for comment before releasing the final version by summer, when plans are preparing their annual member materials.

On April 4, CMS released the 2019 Final Rule, which contains a number of policy changes to the MMG, such as updating the definition of marketing and allowing electronic delivery of certain beneficiary documents. To meet the timeframes for these policy changes, CMS provided a summary of proposed changes to the MMG, instead of a draft version of the MMG, for comment 10 days after the 2019 Final Rule was released. The comment period ended April 26, and the final MMG, to be renamed Medicare Communications and Marketing Guidelines (MCMG) will be released later this year. Click read the full article 
BluePeak Service Spotlight: Member Material Review

BluePeak’s consultants have experience reviewing member materials from their work at Plans and for the Centers for Medicare and Medicaid Services (CMS). We can help you populate and/or review the annual required materials, as well as other member communications, such as Explanation of Benefits (EOBs), transition letters, denial notices, etc., that, if in error or not easily understood, could potentially result in program audit conditions. This could be a huge cost saver in time and money for your organization.
For more information about this service, click here or contact us today for a free consultation.
ICYMI - BluePeak's Articles Posted Recently on LinkedIn
Are you IN? Follow BluePeak Advisors on LinkedIn to receive up-to-date, in-depth information and be IN the know on industry issues.
BluePeak Connection service helps connect our clients with excellent candidates that have proven experience in the marketplace. BluePeak has an extensive network of candidates in compliance, pharmacy, claims, operations and other areas.

Whether you are looking for a short term, long term or permanent staffing placement, let BluePeak connect you with the next member of your team. 
join us at this upcoming event

Babette Edgar,  Principal 
Melissa Whitley, VP Client Services
June 19-21, 2018 : Baltimore, MD


Logo
  Looking for Your Free Consultation?