MetaStar, Inc. and PSRx Advisors, LLC are partnering to provide Data Validation Readiness (DVR) assessments as mandated requirements from the Centers for Medicare & Medicaid Services (CMS) begin to bear down on Plan Sponsors of Medicare Advantage (Part C) and pharmacy benefit (Part D) programs.
Effective with calendar year 2010, CMS now requires Medicare Advantage, Medicare Advantage Prescription Drug (MA-PD) and Prescription Drug Plan (PDP) sponsors to maintain ongoing monitoring of their Medicare Part C and D programs. Plan Sponsors are beginning the process of analyzing the selection of a Data Validation Contractor and assessing their Q1 2011 DVR reporting budgets.
An independent look at an organization’s state of readiness will help guide next steps. An assessment of Data Validation Readiness from the MetaStar and PSRx partnership provides Plan Sponsors with a first step review of:
- Gap analysis of policies, procedures and required data
- Full review on all Part C and D criteria
- Recommendations on completing the Organizational Assessment Instrument (OAI)
- A strategy discussion to walk-through findings and recommendations, including vendor selection strategy or referrals (where desired)
- Budget support for recommended actions including a high/low dollar range with associated assumptions and calculations
The approach to Data Validation Readiness from MetaStar and PSRx offers a low-cost, low-impact method that helps Plan Sponsors understand what they need to do by:
- Reviewing existing documentation via a high-level gap analysis or in-depth “Mock Audit”
- Facilitating one or two day on-site “workshops” with key staff to familiarize them with the new requirements
- Comparing an organization’s specific information against each regulation to identify gaps in data and policy
- Summarizing findings, providing recommendations and presenting a strategy call
The combined experience of the MetaStar and PSRx staffs provides superior expertise in Part C and D audits, and data analysis that uniquely qualifies us to help scope the impact of new regulations on an organization. Independent analysis provides an unbiased view of a Plan Sponsor’s state of readiness. Budget range and methodology makes planning simpler.
About MetaStar, Inc.
MetaStar Inc, based in Madison, WI, is a licensed NCQA HEDIS Compliance Audit™ Firm dedicated to ensuring effective, efficient and collaborative health care data validation services. Using objective, time-proven techniques, we work with providers and sponsors to validate processes and data, assuring the organization’s ability to meet critical reporting requirements. We do it by being an independent, credible, reliable resource for data validation.
About PSRx Advisors, LLC
PSRx Advisors provides pharmacy benefits management consulting and audit services to drive solutions for unions, public employee groups and state and federal programs. PSRx Advisors’ applications and audits are powered by TRICAST, Inc. For more information, visit www.psrx.com.
More Information
Click here to request further information, or contact:
Amy W. Cleary, MBA, CHCA, CPHQ
Part C/D Data Validation Project Lead
(800) 362-2320, ext. 8220
HEDIS Compliance AuditTM is a trademark of the National Committee for Quality Assurance (NCQA).
Copyright © 2010, PSRx Advisors, LLC, used by permission |