Compliance

FDR Requirements:

Is your office fully compliant? As a First Tier, Downstream, Related Entity, you are required to meet CMS expectations to maintain a fully compliant status with regard to your Medicare Advantage and Part D contracts.

Who does this affect?

As a contracted agent you are required to complete certification covering Code of Conduct, General Compliance, and Fraud Waste & Abuse training. Attention required: It is also mandatory to train and educate any employee who performs any service involving the receipt of; the processing of; the transferring of; the handling of; the storage of; OR has access to Medicare Advantage or Part D beneficiary PHI.  All requirements apply to contracted agents as well as employees who are not contracted agents but who work in any way on the MA or Part D programs.

What, When and How often?

Fraud, Waste & Abuse and General Compliance: must be completed within 90 days of hire for all new employees and Annually thereafter.
The UHC Code of Conduct: must be completed within 90 days of hire for all new employees and Annually thereafter.
Exclusion/ Sanction/ Debarment Checks: OIG & GSA Exclusions checks must be completed prior to hire and monthly thereafter.

For a full copy of the delegate regulatory requirements, click HERE

Sanction/Exclusion/Debarment checks can be completed on these two links:
http://oig.hhs.gov/exclusions/index.asp
and
https://www.sam.gov/index.html/##11

Additional Requirements:
Communicate requirement to any Vendors/Contractors and obtain attestation of compliance to all requirements as applicable
Demonstrate oversight of all contracted agents/agencies for compliance with all FDR regulations.

Please contact us at Oberlin Marketing for training slides, training logs, explanations or any questions at all. All training and checks require documentation including training logs and screenprints. We appreciate your attention to compliance and will help in any way we can!