General Compliance and Fraud, Waste & Abuse
The Centers for Medicare and Medicaid Services (CMS) require that Medicare Advantage organizations inform network providers and practitioners about the requirements to complete annual training. In 2018, the required trainings for Wellcare By Allwell are:
- General Compliance (Compliance)
- Fraud, Waste, and Abuse (FWA)*
For General Compliance and Fraud, Waste, and Abuse*
Effective January 1, 2016, First-Tier, Downstream, and Related Entities (FDR), as well as delegated entities, will be required to complete training via the Medicare Learning Network (MLN) website. The trainings must be completed by each individual provider/practitioner within the group rather than one person representing the group collectively. The updated regulation requires all applicable entities (providers, practitioners, administrators) to complete the training within 90 days of contracting or becoming a delegated entity and annually thereafter. Once the training is completed, each applicable entity will need to complete the certificate(s) of completion or attestation through the CMS MLN and provide a copy to Wellcare By Allwell.
*Note: FDRs deemed to 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 DMEPOS are exempt from the FWA training requirement only (General Compliance training remains a requirement),
To complete General Compliance and FWA training (if applicable) and access your certificate of completion:
- Visit the CMS MLN site: Refer to Combating Medicare Parts C and D Fraud, Waste, & Abuse (MLN3995723) and the Medicare Provider Compliance Tips applicable for your practice (MLN4824456).
- Please send a copy of the FWA certificate of completion to Provider_Training@sunflowerhealthplan.com.
Please note that when you complete the attestation form, remember to include all tax identification numbers (TIN) that you are representing.
| Training | Location | Signed Attestation(s) From | Attestation Method |
|---|---|---|---|
| General Compliance | CMS MLN | Each applicable provider, practitioner, administrator (entities classified as FDR) | Send a copy of the CMS certificate of completion to Sunflower Health Plan at: Provider_Training@sunflowerhealthplan.com |
| Fraud, Waste, and Abuse | CMS MLN | Each applicable provider, practitioner, administrator (entities classified as FDR) | Send a copy of the CMS certificate of completion to Sunflower Health Plan at: Provider_Training@sunflowerhealthplan.com |
Wellcare By Allwell is committed to working with you to fulfill these CMS requirements. If you need additional information, please contact Provider Services at 1-855-565-9519.
Thank you for your participation. We look forward to working with you to provide quality medical services and healthcare coverage to our Medicare Advantage members.