Peak Health Plan Management Adds New Precluded Provider Report to Portfolio of Services

News | 2 Minute Read

Moorestown, NJ and St. Louis, MO (March 26, 2019) – Capstone Performance Systems, a St. Louis company offering comprehensive consulting and services to Programs of All-inclusive Care for the Elderly (PACE) and other at-risk healthcare organizations, today announced a new Precluded Providers report to be offered by its Peak Health Plan Management service line. PACE is a federal program benefiting individuals 55 and older who are nursing home eligible. PACE includes 240 centers in 31 states serving a growing number of eligible Medicare and Medicaid participants. The goal of the program is to keep participants living at home in their communities for as long as possible.

On January 1, 2019, the US Centers for Medicare and Medicaid Services (CMS) published a Precluded Providers list of healthcare providers and prescribers who are barred from receiving payment for services, health care items or Part D drugs furnished or prescribed to Medicare beneficiaries. Effective April 1, 2019, PACE organizations must reject or deny payments for those services furnished or prescribed by providers and prescribers on the preclusion list.

“We are pleased to announce Peak’s new service, which will be provided to clients at no additional cost,” said Patty Bailey, CEO of Peak Health Plan Management. “The Precluded Provider service will help ensure our clients remain compliant with CMS regulations.”

Peak will compare each plan’s providers to the monthly preclusion list and report the results to the client. The new offering is one of several enhancements to customer services that Peak has implemented since being acquired by Capstone in 2018. The Peak team is committed to working with clients to improve efficiency and satisfaction.

For more information, email Peak Health Plan Management at or call (314) 474-7342.

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