M3P Implementation: A Strategic Guide for Timely and Successful Rollout
Plans can achieve a seamless and timely M3P implementation through a strategic approach. In a recent blog, we outlined the Medicare…
Government Program Services
SOLUTIONS
Government Program Services
PSG offers strategic advisory services to employers, health plans, PBMs, and other government-funded benefits service providers. Our pharmacists and compliance experts specialize in Medicare, Medicaid, and Federal Employees Health Benefits with experience creating compliant and innovative solutions in the competitive and regulated world of government programs.
avg years of team’s relevant experience
government program lives managed
carve out services
Strategic Consulting
PSG supports government program strategy development, gap analysis, scenario planning, and more to help clients plan for successful futures. Our comprehensive consulting services can be customized to meet your government program needs.
Product Lifecycle Support
From PSG Modular PBA® to Medicare start-ups, our clients count on PSG’s innovative thinking and industry knowledge to bring their visions to life.
Vendor Oversight
Our trusted advisors act as an extension of your team to help you operate effective vendor accountability and relationship management systems.
Crisis Management and Reputation Maintenance
Our team prepares clients for challenges they may face and provides corrective redirection if something has gone awry.
Policy Clarifications
PSG’s policy experts can bring clarity to Medicare, Medicaid, and Federal Employee Health Benefits Program (FEHB) rules in real-world situations.
Staffing and Partner Support
PSG staffing models support clients during key position vacancies and help clients find the right vendor partnerships to execute company goals.
Health Equity and Outcomes Improvement
Beginning 1/1/2025, all Medicare Advantage plans must include a Health Equity expert on its Utilization Management Committee. PSG has health equity expertise ready to help plans meet and exceed this requirement.
List of Services
| Benefit Validation Testing | Claim Platform Compliance Evaluation | Clinical Consulting | CMS Corrective Action Plan (CAP) and Remediation |
| CMS Medicare Application and Service Area Expansion | CMS Program Audit Support | Compliance Program Development | Coverage Determination Appeals (CDAG) and Organization Determination Appeals and Grievances (ODAG) Oversight |
| Delegation Oversight | End Stage Renal Disease (ESRD) Retrospective Review | FEHP Application Support | Formulary Development Strategy |
| Hospice Retrospective Review | Inflation Reduction Act Strategy | Medicare and Medicaid Support | Medicare Portfolio Diversification |
| Medicare Prescription Payment Plan (M3P) Procurement, Implementation, and Audit | Medicare Product Development | Medicare Solutions Notebook | Mock Audit Prep |
| PBM Market Check | Pharmacy and Compliance Staffing | Pre-Delegation Audits | Prescription Drug Event (PDE) Audits |
| Quality and Star Ratings Strategy | Regulatory Analysis and Policy Clarifications | Utilization Management Compliance Evaluation | Website and Marketing Consulting |