BluePeak Advisors and Solid Benefit Guidance, under Gallagher Benefit Services, Inc., work together to enhance services to all our clients. Clients can take advantage of our division’s individual expertise and specialty or combine resources to customize a project to meet all your needs.
CMS compliance and operations support, CMS Audit support and Interim staffing
BluePeak Advisors was founded in 2010 by a group of government healthcare professionals dedicated to solving the Medicare and Medicaid Programs’ unique regulatory and operational challenges. Led by Babette Edgar and Sherry Pound, BluePeak supports government sponsored health organizations with all aspects of compliance, operations and strategy. As part of our vast federal experience, we have helped a number of organizations navigate State regulations under Medicaid and ACA programs.
State Medicaid programs all receive Federal funding support; however, each state is individualized in the administration and oversight of these plans. There are differences in the oversight of these plans from state to state with some states being more prescriptive in both requirements and oversight. Each state has regular reporting requirements, and audits are conducted of those plans similar to the Medicare process for Medicare Advantage Prescription Drug (MAPD) program audits. Programs include Medicaid Managed Care, Managed Long Term Services and Support (MLTSS) as well as Medicaid Long Term Care (MLTC) programs. BluePeak can supports plan with State audits, conduct mock audits specific to state requirements, evaluate the effectiveness compliance program and operations, such as but not inclusive of Appeals and Grievance reviews, Claim audits. Learn more at www.bluepeak.com
Solid Benefit Guidance
Pharmacy Benefit Management Consulting
Solid Benefit Guidance (SBG) is one of the nation’s leading consulting firms and thought leaders in the PBM industry. With more than 550 years of collective experience, SBG provides ACAP members and health plans around the nation with an unparalleled evaluation of their pharmacy costs, operational support, and management of performance and trends. SBG currently provides PBM consulting services to over 32 health plans and has touched on over 60 million Rx lives, about 10% of the population of the United States. SBG has extensive expertise in the management and support of managed Medicaid and Medicare Part-D pharmacy programs, including Medicare Special Needs Plans and Medicaid long-term care programs. When you know how it works on the inside, you have an edge! Learn more at www.sbgbenefits.com
Area Senior Vice President, Health Plan Service Consulting
Melissa Whitley, EMBA, CHC
VP, Client Services, Health Plan Service Consulting
Senior Vice President, Pharmacy Practice
Solid Benefit Guidance