The Centers for Medicare and Medicaid Services (CMS) requires Medicare Advantage Organizations and Part D sponsors to ensure that general compliance and fraud, waste, and abuse (FWA) training and education is communicated to their FDRs who have involvement in the administration or delivery of Medicare Parts C and D benefits. As a result, all FDR employees that are involved in the delivery or administration of services for CareFirst Medicare Advantage’s Medicare plans must take this training.
FDR required trainings include:
FDRs may click here to access CMS’s Medicare Learning Network® Learning Management System to log in and take CMS’s FWA and General Compliance Training
The Model of Care Training purpose is to ensure the unique needs for beneficiaries who are enrolled in an SNP plan are identified. As a Medicare Advantage Organization offering a Dual-Special Needs plan, we must ensure all network providers and FDRs who provide or arrange for healthcare services to our members complete the company’s Model of Care Training at the time of contracting an annually thereafter.
Standards of Conduct, also known in some organizations as the “Code of Conduct” or by other similar names, state the overarching principles and values by which the company operates, and define the underlying framework for the compliance policies and procedures. Code of Conduct describes expectations that all employees conduct themselves in an ethical manner with issues of noncompliance and potential FWA required to be reported through appropriate mechanisms, etc. CMS requires the communication of this document to employees and FDR employees. We developed and maintain the University of Maryland Health Advantage Code of Ethical Business Conduct and Compliance for First Tier, Downstream and Related Entities.
There is one exception for FWA Training. FDRs who have met the FWA certification requirements through enrollment into Parts A or B of the Medicare program or through accreditation as a supplier of DMEPOS are deemed to have met the CMS FWA training requirements. Deeming is at the level of the entity’s participation/accreditation (whether for the individual or entire organization).