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Medicare FDRs

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Medicare FDR Training & Education

Welcome Medicare FDRs!

We’re pleased to announce that Aetna’s acquisition of Coventry Health Care, Inc. is now complete. Aetna and Coventry, as a combined organization, share a commitment to creating mutually beneficial relationships with our First Tier, Downstream and Related Entities (FDRs). You have been directed to this website because you recently contracted with us to provide administrative and/or health care services for our Medicare Advantage and/or Medicare prescription drug products (collectively, “Medicare products”) and, therefore, you are a “first tier entity”, as defined by the Centers for Medicare & Medicaid Services (“CMS”). As a first tier entity, you must comply with the CMS Medicare Compliance Program requirements. The FDR Medicare Compliance Program Guide (“FDR Guide”), found at the link below, provides a summary of the Medicare Compliance Program requirements. These requirements apply to you/your organization as a first tier entity, any of your downstream entities and/or your individual employees who are assigned to perform services for our Medicare products, as further described in the FDR Guide.

In addition, to assist you with complying with the training requirements described in the FDR Guide, below you will also find the CMS “Medicare Parts C & D Fraud, Waste, and Abuse Training and General Compliance Training” and a sample “Employee training attendance log” , which can be used to track completion of the required training.

Please review the FDR Guide and confirm that you have internal processes to support your compliance with all of these Medicare Compliance Program requirements. These requirements include, but are not limited to, completion of the required initial FWA training within 90 days of hire/contracting. You are required to maintain evidence of your compliance with these Medicare Compliance Program requirements (e.g., employee and downstream entity employee training records, CMS certificate of completion, etc.) for at least ten (10) years, as further described in your contract with Aetna.

Aetna takes our responsibility to comply with the Medicare Compliance Program requirements very seriously. A member of Aetna’s Medicare Compliance team may contact the designated Compliance personnel within your organization to further discuss your organization’s compliance program and compliance with these requirements. You may access the Aetna Code of Conduct and Medicare Compliance policies and procedures through the links provided in the FDR Guide or using the links below. If you have questions or concerns regarding any of these requirements or would like to receive a hardcopy version, please contact your appropriate Coventry/Aetna representative or MedicareFDR@aetna.com

DOCUMENT LINKS

FDR Guide

Medicare Parts C & D Fraud, Waste, and Abuse Training and General Compliance Training

Employee training attendance log

Aetna Code of Conduct

Medicare Compliance policies and procedures 

ATTESTATION


An authorized representative from your organization is required to complete the Aetna First Tier Compliance Attestation (on behalf of your organization) on an annual basis to attest to your organization’s awareness, completion and compliance with these Medicare Compliance Program requirements. The format of the attestation varies depending upon the type of first tier entity (provider, broker organization, vendor, etc.). You will be contacted directly with instructions for completing each year's attestation.

In addition, for monitoring and auditing purposes, Aetna and/or CMS may request that you provide evidence of your compliance with these requirements. Aetna may pursue remedies available under our contract with you if you do not comply with the Medicare Compliance Program requirements. These remedies will vary depending on the extent of your non-compliance and may include requiring that you implement a corrective action plan, termination of services you provide for Aetna’s Medicare products, and/or contract termination.


FREQUENTLY ASKED QUESTIONS

FAQs
A list of frequently asked questions (FAQs) is available for your reference through the link on the left. If you have additional questions not addressed by the FAQs, please feel free to contact your appropriate Aetna/Coventry representative or email MedicareFDR@aetna.com.

Please be reminded this training must be completed within 90 days of hire/contracting and annually thereafter AND you must maintain evidence of completion for no less than ten (10) years. Aetna and/or CMS may request evidence of completion from you and/or your downstream entities for these training and education requirements.



Downloadable Materials

The training can be completed on this website or downloaded to an individual(s) computer(s).

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