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New PSRx Advisors Partnership with MetaStar Assists Plan Sponsors on Mandated CMS Part C & Part D Data Validation Readiness (DVR)

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 Part D programs. Plan Sponsors needing a DVR 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 {with a DVR} will help guide next steps. An assessment of Data Validation Readiness from the PSRx & MetaStar partnership, with data warehousing and analysis conducted by TRICAST, Inc., provides Plan Sponsors with a first step review of:

• Gap analysis of policies, procedures and required data

• Full review on all CMS Part C and Part D criteria

• Recommendations on completing the Organizational Assessment Instrument (OAI)

• A strategy document with DVR 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 PSRx & MetaStar 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 Centers for Medicare & Medicaid Services regulation to identify gaps in data and policy

• Summarizing Data Validation findings and providing recommendations

The combined experience of the PSRx & MetaStar staffs, with technology powered by TRICAST, provides superior expertise in CMS Part C and Part 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 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 please visit us at www.psrx.com.

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. To learn more, visit www.metastar.com.

HEDIS Compliance Audit^TM is a trademark of the National Committee for Quality Assurance (NCQA).

Michael Beightol, Coyote Marsh & Associates, Inc.
mbeightol@coyotemarsh.com; 847-277-7353