If your practice or facility cares for Medicare-eligible patients, please read this important notice and share it with your colleagues.
|Q||What kind of training is required by the Centers for Medicare & Medicaid Services (CMS)?|
CMS requires Highmark’s Medicare First-tier, Downstream, and Related (FDR) Entities to complete two trainings:
|Q||Who must complete these trainings?|
Individuals associated with your practice or facility who work with Highmark’s Medicare Advantage and/or Medicare Part D Prescription Drug Plan (PDP) members and who fall into one of these categories:
|Q||Why does CMS require these individuals to complete these trainings?|
|A||CMS expects Highmark and its other Medicare-plan sponsors to ensure that all practices and facilities receiving Medicare dollars understand how to comply with the laws, regulations, guidelines, and policies for the Medicare program and how to prevent, detect, and correct Medicare fraud, waste, and abuse.|
|Q||When does CMS require these individuals to complete these trainings?|
|A||Both trainings must be completed:
|Q||Where can individuals go to access these trainings?|
|A||Individuals have three options for completing these training requirements. They can:
|Q||What proof must be provided that the trainings were completed?|
|A||Individuals must review the training programs in their entirety, and there must be some form of evidence that each individual completed the training. Acceptable forms of evidence include:
|Q||Are there any exceptions to these guidelines?|
Yes. FDRs who have met the FWA training and education certification requirements through enrollment into Parts A or B of the Medicare program or through accreditation as a supplier of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) are deemed to have met the training and educational requirements for fraud, waste, and abuse. However, these individuals are not exempt from the general compliance training requirement (the training is still required).