To help organizations answer some questions that have recently been asked, we thought it would be helpful to “throwback” to our Cover Your Attestation article series.
Why are insurance companies asking for Annual Compliance Attestation? What are the Medicare requirements? Are you required to complete the attestation? How can we help you with the attestation process?
To answer these questions, we have created a two part article series. In this first part of our Cover Your Attestation article series, we will discuss why insurance companies are asking for Annual Compliance Attestation.
In the next few weeks we will publish the second part of the article series. This second article will discuss applicable requirements to help you further Cover Your Attestation Requirements.
In addition to Meaningful Use Attestation requirements, many insurance companies are asking for Annual Compliance Attestation for organizations to validate compliance with applicable requirements.
CMS requires oversight of FDRs (first-tier, downstream, and related entities) for all Medicare Advantage plan sponsors. Insurance companies have developed annual attestation compliance attestation to validate that each contracted FDR has met CMS requirements.
The electronic attestation must be completed by an individual in your organization who has signatory authority to make the representations in the attestation. You should enter and submit each additional NPI (National Provider Identifier) you have signatory authority for during the attestation process.
Fraud, Waste, Abuse and Compliance Training
Medicare plan sponsors are required to communicate their general compliance expectations to their FDRs through distribution of the plan sponsor’s Standards of Conduct and/or compliance policies and procedures to FDRs’ employees. FDRs’ employees who have involvement in the administration or delivery of Parts C and D benefits, must, at a minimum, receive Fraud, Waste and Abuse (FWA) training within 90 days of initial hiring/contracting, and annually thereafter. Plan sponsors must be able to verify that their FDRs have fulfilled these training requirements.