GPS Medicare Part D Experience
The team’s background combined with its focused efforts in Medicare Part D program administration and operations have allowed the GPS consultants to develop innovative and effective Medicare solutions to a variety of pharmacy benefit sponsors, administrators and managed care organizations. GPS consultants have implemented and administered:
• Medicare RDS programs with services including application maintenance, eligibility submissions and maintenance, communications, interim cost report generation and submissions, reconciliation activities, over/under payment identification as well as auditing and compliance.
• Employer Group Waiver Plan (EGWP) direct contract Medicare Prescription Drug Plans (PDP) with services including program operations and administration, bid and application development and submission, eligibility maintenance and error resolution services, prescription drug event data (PDE) submission and maintenance services, reconciliation activities, communications and document development, full-scope compliance program administration including auditing.
• “800 Series” EGWPs offering enhanced benefit arrangements with services including program bidding and placement, implementation, integration of alternate funding arrangements, program performance and renewal negotiations and contracting.
GPS consultants have audited commercial Medicare PDP and MA-PD prescription drug administrators’ PDE reporting processes for compliance with CMS requirements and sub-regulatory guidance.
GPS consultants have participated in CMS sponsored training programs and focus groups related to PDP/MA-PD, EGWP (“800 Series” and Direct) and RDS administration and compliance.
Medicare Services
- GPS can provide administration support and/or consulting services for the following Medicare programs:
PDP / MA-PD |
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Retiree Drug Subsidy (RDS) |
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“800 Series” or Wrap |
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